{"abstract":"This final rule sets forth routine updates to the Medicare home health payment rates for calendar year (CY) 2023 in accordance with existing statutory and regulatory requirements. This final rule also finalizes a methodology for determining the impact of the difference between assumed versus actual behavior change on estimated aggregate expenditures for home health payments as result of the change in the unit of payment to 30 days and the implementation of the Patient Driven Groupings Model (PDGM) case-mix adjustment methodology and finalizes a corresponding permanent prospective adjustment to the CY 2023 home health payment rate. This rule finalizes the reassignment of certain diagnosis codes under the PDGM case-mix groups, and establishes a permanent mitigation policy to smooth the impact of year-to-year changes in home health payments related to changes in the home health wage index. This rule also finalizes recalibration of the PDGM case-mix weights and updates the low utilization payment adjustment (LUPA) thresholds, functional impairment levels, comorbidity adjustment subgroups for CY 2023, and the fixed-dollar loss ratio (FDL) used for outlier payments. Additionally, this rule discusses comments received on the future collection of data regarding the use of telecommunications technology during a 30-day home health period of care on home health claims. This rule also finalizes changes to the Home Health Quality Reporting Program (HH QRP) requirements; changes to the expanded Home Health Value-Based Purchasing (HHVBP) Model; and updates to the home infusion therapy services payment rates for CY 2023.","action":"Final rule.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2022/11/04/2022-23722.html","cfr_references":[{"chapter":null,"citation_url":null,"part":"484","title":42}],"citation":"87 FR 66790","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"These regulations are effective on January 1, 2023.","disposition_notes":null,"docket_ids":["CMS-1766-F"],"dockets":[{"supporting_documents":[],"agency_name":"CMS","documents":[{"comment_count":0,"comment_start_date":"2022-11-04","updated_at":"2023-02-27T21:04:34.073-05:00","comment_url":"https://www.regulations.gov/commenton/CMS-2022-0109-0888","allow_late_comments":null,"id":"CMS-2022-0109-0888","comment_end_date":"2022-11-05","regulations_dot_gov_open_for_comment":false}],"supporting_documents_count":0,"id":"CMS-2022-0109","title":"CY 2023 Home Health Prospective Payment System Rate Update and Home Infusion Therapy Services Payment Update (CMS-1766-P)"}],"document_number":"2022-23722","effective_on":"2023-01-01","end_page":66887,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2022/11/04/2022-23722.xml","html_url":"https://www.federalregister.gov/documents/2022/11/04/2022-23722/medicare-program-calendar-year-cy-2023-home-health-prospective-payment-system-rate-update-home","images":{"ER04NO22.019":{"large":"https://img.federalregister.gov/ER04NO22.019/ER04NO22.019_large.png","medium":"https://img.federalregister.gov/ER04NO22.019/ER04NO22.019_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.019/ER04NO22.019_original_size.png"},"ER04NO22.018":{"large":"https://img.federalregister.gov/ER04NO22.018/ER04NO22.018_large.png","medium":"https://img.federalregister.gov/ER04NO22.018/ER04NO22.018_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.018/ER04NO22.018_original_size.png"},"ER04NO22.017":{"large":"https://img.federalregister.gov/ER04NO22.017/ER04NO22.017_large.png","medium":"https://img.federalregister.gov/ER04NO22.017/ER04NO22.017_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.017/ER04NO22.017_original_size.png"},"ER04NO22.016":{"large":"https://img.federalregister.gov/ER04NO22.016/ER04NO22.016_large.png","medium":"https://img.federalregister.gov/ER04NO22.016/ER04NO22.016_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.016/ER04NO22.016_original_size.png"},"ER04NO22.015":{"large":"https://img.federalregister.gov/ER04NO22.015/ER04NO22.015_large.png","medium":"https://img.federalregister.gov/ER04NO22.015/ER04NO22.015_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.015/ER04NO22.015_original_size.png"},"ER04NO22.014":{"large":"https://img.federalregister.gov/ER04NO22.014/ER04NO22.014_large.png","medium":"https://img.federalregister.gov/ER04NO22.014/ER04NO22.014_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.014/ER04NO22.014_original_size.png"},"ER04NO22.058":{"large":"https://img.federalregister.gov/ER04NO22.058/ER04NO22.058_large.png","medium":"https://img.federalregister.gov/ER04NO22.058/ER04NO22.058_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.058/ER04NO22.058_original_size.png"},"ER04NO22.013":{"large":"https://img.federalregister.gov/ER04NO22.013/ER04NO22.013_large.png","medium":"https://img.federalregister.gov/ER04NO22.013/ER04NO22.013_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.013/ER04NO22.013_original_size.png"},"ER04NO22.057":{"large":"https://img.federalregister.gov/ER04NO22.057/ER04NO22.057_large.png","medium":"https://img.federalregister.gov/ER04NO22.057/ER04NO22.057_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.057/ER04NO22.057_original_size.png"},"ER04NO22.012":{"large":"https://img.federalregister.gov/ER04NO22.012/ER04NO22.012_large.png","medium":"https://img.federalregister.gov/ER04NO22.012/ER04NO22.012_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.012/ER04NO22.012_original_size.png"},"ER04NO22.056":{"large":"https://img.federalregister.gov/ER04NO22.056/ER04NO22.056_large.png","medium":"https://img.federalregister.gov/ER04NO22.056/ER04NO22.056_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.056/ER04NO22.056_original_size.png"},"ER04NO22.011":{"large":"https://img.federalregister.gov/ER04NO22.011/ER04NO22.011_large.png","medium":"https://img.federalregister.gov/ER04NO22.011/ER04NO22.011_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.011/ER04NO22.011_original_size.png"},"ER04NO22.055":{"large":"https://img.federalregister.gov/ER04NO22.055/ER04NO22.055_large.png","medium":"https://img.federalregister.gov/ER04NO22.055/ER04NO22.055_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.055/ER04NO22.055_original_size.png"},"ER04NO22.010":{"large":"https://img.federalregister.gov/ER04NO22.010/ER04NO22.010_large.png","medium":"https://img.federalregister.gov/ER04NO22.010/ER04NO22.010_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.010/ER04NO22.010_original_size.png"},"ER04NO22.054":{"large":"https://img.federalregister.gov/ER04NO22.054/ER04NO22.054_large.png","medium":"https://img.federalregister.gov/ER04NO22.054/ER04NO22.054_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.054/ER04NO22.054_original_size.png"},"ER04NO22.053":{"large":"https://img.federalregister.gov/ER04NO22.053/ER04NO22.053_large.png","medium":"https://img.federalregister.gov/ER04NO22.053/ER04NO22.053_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.053/ER04NO22.053_original_size.png"},"ER04NO22.052":{"large":"https://img.federalregister.gov/ER04NO22.052/ER04NO22.052_large.png","medium":"https://img.federalregister.gov/ER04NO22.052/ER04NO22.052_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.052/ER04NO22.052_original_size.png"},"ER04NO22.051":{"large":"https://img.federalregister.gov/ER04NO22.051/ER04NO22.051_large.png","medium":"https://img.federalregister.gov/ER04NO22.051/ER04NO22.051_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.051/ER04NO22.051_original_size.png"},"ER04NO22.050":{"large":"https://img.federalregister.gov/ER04NO22.050/ER04NO22.050_large.png","medium":"https://img.federalregister.gov/ER04NO22.050/ER04NO22.050_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.050/ER04NO22.050_original_size.png"},"ER04NO22.029":{"large":"https://img.federalregister.gov/ER04NO22.029/ER04NO22.029_large.png","medium":"https://img.federalregister.gov/ER04NO22.029/ER04NO22.029_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.029/ER04NO22.029_original_size.png"},"ER04NO22.028":{"large":"https://img.federalregister.gov/ER04NO22.028/ER04NO22.028_large.png","medium":"https://img.federalregister.gov/ER04NO22.028/ER04NO22.028_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.028/ER04NO22.028_original_size.png"},"ER04NO22.027":{"large":"https://img.federalregister.gov/ER04NO22.027/ER04NO22.027_large.png","medium":"https://img.federalregister.gov/ER04NO22.027/ER04NO22.027_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.027/ER04NO22.027_original_size.png"},"ER04NO22.026":{"large":"https://img.federalregister.gov/ER04NO22.026/ER04NO22.026_large.png","medium":"https://img.federalregister.gov/ER04NO22.026/ER04NO22.026_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.026/ER04NO22.026_original_size.png"},"ER04NO22.025":{"large":"https://img.federalregister.gov/ER04NO22.025/ER04NO22.025_large.png","medium":"https://img.federalregister.gov/ER04NO22.025/ER04NO22.025_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.025/ER04NO22.025_original_size.png"},"ER04NO22.024":{"large":"https://img.federalregister.gov/ER04NO22.024/ER04NO22.024_large.png","medium":"https://img.federalregister.gov/ER04NO22.024/ER04NO22.024_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.024/ER04NO22.024_original_size.png"},"ER04NO22.023":{"large":"https://img.federalregister.gov/ER04NO22.023/ER04NO22.023_large.png","medium":"https://img.federalregister.gov/ER04NO22.023/ER04NO22.023_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.023/ER04NO22.023_original_size.png"},"ER04NO22.022":{"large":"https://img.federalregister.gov/ER04NO22.022/ER04NO22.022_large.png","medium":"https://img.federalregister.gov/ER04NO22.022/ER04NO22.022_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.022/ER04NO22.022_original_size.png"},"ER04NO22.021":{"large":"https://img.federalregister.gov/ER04NO22.021/ER04NO22.021_large.png","medium":"https://img.federalregister.gov/ER04NO22.021/ER04NO22.021_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.021/ER04NO22.021_original_size.png"},"ER04NO22.020":{"large":"https://img.federalregister.gov/ER04NO22.020/ER04NO22.020_large.png","medium":"https://img.federalregister.gov/ER04NO22.020/ER04NO22.020_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.020/ER04NO22.020_original_size.png"},"ER04NO22.039":{"large":"https://img.federalregister.gov/ER04NO22.039/ER04NO22.039_large.png","medium":"https://img.federalregister.gov/ER04NO22.039/ER04NO22.039_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.039/ER04NO22.039_original_size.png"},"ER04NO22.038":{"large":"https://img.federalregister.gov/ER04NO22.038/ER04NO22.038_large.png","medium":"https://img.federalregister.gov/ER04NO22.038/ER04NO22.038_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.038/ER04NO22.038_original_size.png"},"ER04NO22.037":{"large":"https://img.federalregister.gov/ER04NO22.037/ER04NO22.037_large.png","medium":"https://img.federalregister.gov/ER04NO22.037/ER04NO22.037_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.037/ER04NO22.037_original_size.png"},"ER04NO22.036":{"large":"https://img.federalregister.gov/ER04NO22.036/ER04NO22.036_large.png","medium":"https://img.federalregister.gov/ER04NO22.036/ER04NO22.036_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.036/ER04NO22.036_original_size.png"},"ER04NO22.035":{"large":"https://img.federalregister.gov/ER04NO22.035/ER04NO22.035_large.png","medium":"https://img.federalregister.gov/ER04NO22.035/ER04NO22.035_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.035/ER04NO22.035_original_size.png"},"ER04NO22.034":{"large":"https://img.federalregister.gov/ER04NO22.034/ER04NO22.034_large.png","medium":"https://img.federalregister.gov/ER04NO22.034/ER04NO22.034_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.034/ER04NO22.034_original_size.png"},"ER04NO22.033":{"large":"https://img.federalregister.gov/ER04NO22.033/ER04NO22.033_large.png","medium":"https://img.federalregister.gov/ER04NO22.033/ER04NO22.033_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.033/ER04NO22.033_original_size.png"},"ER04NO22.032":{"large":"https://img.federalregister.gov/ER04NO22.032/ER04NO22.032_large.png","medium":"https://img.federalregister.gov/ER04NO22.032/ER04NO22.032_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.032/ER04NO22.032_original_size.png"},"ER04NO22.031":{"large":"https://img.federalregister.gov/ER04NO22.031/ER04NO22.031_large.png","medium":"https://img.federalregister.gov/ER04NO22.031/ER04NO22.031_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.031/ER04NO22.031_original_size.png"},"ER04NO22.030":{"large":"https://img.federalregister.gov/ER04NO22.030/ER04NO22.030_large.png","medium":"https://img.federalregister.gov/ER04NO22.030/ER04NO22.030_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.030/ER04NO22.030_original_size.png"},"ER04NO22.009":{"large":"https://img.federalregister.gov/ER04NO22.009/ER04NO22.009_large.png","medium":"https://img.federalregister.gov/ER04NO22.009/ER04NO22.009_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.009/ER04NO22.009_original_size.png"},"ER04NO22.008":{"large":"https://img.federalregister.gov/ER04NO22.008/ER04NO22.008_large.png","medium":"https://img.federalregister.gov/ER04NO22.008/ER04NO22.008_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.008/ER04NO22.008_original_size.png"},"ER04NO22.007":{"large":"https://img.federalregister.gov/ER04NO22.007/ER04NO22.007_large.png","medium":"https://img.federalregister.gov/ER04NO22.007/ER04NO22.007_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.007/ER04NO22.007_original_size.png"},"ER04NO22.006":{"large":"https://img.federalregister.gov/ER04NO22.006/ER04NO22.006_large.png","medium":"https://img.federalregister.gov/ER04NO22.006/ER04NO22.006_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.006/ER04NO22.006_original_size.png"},"ER04NO22.005":{"large":"https://img.federalregister.gov/ER04NO22.005/ER04NO22.005_large.png","medium":"https://img.federalregister.gov/ER04NO22.005/ER04NO22.005_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.005/ER04NO22.005_original_size.png"},"ER04NO22.049":{"large":"https://img.federalregister.gov/ER04NO22.049/ER04NO22.049_large.png","medium":"https://img.federalregister.gov/ER04NO22.049/ER04NO22.049_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.049/ER04NO22.049_original_size.png"},"ER04NO22.004":{"large":"https://img.federalregister.gov/ER04NO22.004/ER04NO22.004_large.png","medium":"https://img.federalregister.gov/ER04NO22.004/ER04NO22.004_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.004/ER04NO22.004_original_size.png"},"ER04NO22.048":{"large":"https://img.federalregister.gov/ER04NO22.048/ER04NO22.048_large.png","medium":"https://img.federalregister.gov/ER04NO22.048/ER04NO22.048_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.048/ER04NO22.048_original_size.png"},"ER04NO22.003":{"large":"https://img.federalregister.gov/ER04NO22.003/ER04NO22.003_large.png","medium":"https://img.federalregister.gov/ER04NO22.003/ER04NO22.003_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.003/ER04NO22.003_original_size.png"},"ER04NO22.047":{"large":"https://img.federalregister.gov/ER04NO22.047/ER04NO22.047_large.png","medium":"https://img.federalregister.gov/ER04NO22.047/ER04NO22.047_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.047/ER04NO22.047_original_size.png"},"ER04NO22.002":{"large":"https://img.federalregister.gov/ER04NO22.002/ER04NO22.002_large.png","medium":"https://img.federalregister.gov/ER04NO22.002/ER04NO22.002_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.002/ER04NO22.002_original_size.png"},"ER04NO22.046":{"large":"https://img.federalregister.gov/ER04NO22.046/ER04NO22.046_large.png","medium":"https://img.federalregister.gov/ER04NO22.046/ER04NO22.046_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.046/ER04NO22.046_original_size.png"},"ER04NO22.001":{"large":"https://img.federalregister.gov/ER04NO22.001/ER04NO22.001_large.png","medium":"https://img.federalregister.gov/ER04NO22.001/ER04NO22.001_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.001/ER04NO22.001_original_size.png"},"ER04NO22.045":{"large":"https://img.federalregister.gov/ER04NO22.045/ER04NO22.045_large.png","medium":"https://img.federalregister.gov/ER04NO22.045/ER04NO22.045_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.045/ER04NO22.045_original_size.png"},"ER04NO22.000":{"large":"https://img.federalregister.gov/ER04NO22.000/ER04NO22.000_large.png","medium":"https://img.federalregister.gov/ER04NO22.000/ER04NO22.000_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.000/ER04NO22.000_original_size.png"},"ER04NO22.044":{"large":"https://img.federalregister.gov/ER04NO22.044/ER04NO22.044_large.png","medium":"https://img.federalregister.gov/ER04NO22.044/ER04NO22.044_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.044/ER04NO22.044_original_size.png"},"ER04NO22.043":{"large":"https://img.federalregister.gov/ER04NO22.043/ER04NO22.043_large.png","medium":"https://img.federalregister.gov/ER04NO22.043/ER04NO22.043_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.043/ER04NO22.043_original_size.png"},"ER04NO22.042":{"large":"https://img.federalregister.gov/ER04NO22.042/ER04NO22.042_large.png","medium":"https://img.federalregister.gov/ER04NO22.042/ER04NO22.042_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.042/ER04NO22.042_original_size.png"},"ER04NO22.041":{"large":"https://img.federalregister.gov/ER04NO22.041/ER04NO22.041_large.png","medium":"https://img.federalregister.gov/ER04NO22.041/ER04NO22.041_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.041/ER04NO22.041_original_size.png"},"ER04NO22.040":{"large":"https://img.federalregister.gov/ER04NO22.040/ER04NO22.040_large.png","medium":"https://img.federalregister.gov/ER04NO22.040/ER04NO22.040_medium.png","original_size":"https://img.federalregister.gov/ER04NO22.040/ER04NO22.040_original_size.png"}},"images_metadata":{"ER04NO22.019":{"large":{"identifier":"ER04NO22.019","content_type":"image/png","size":87235,"width":823,"sha":"c99fc4d6ced4fd329e63e6cd0f757753","url":"https://img.federalregister.gov/ER04NO22.019/ER04NO22.019_large.png","height":1031},"medium":{"identifier":"ER04NO22.019","content_type":"image/png","size":47222,"width":563,"sha":"c4d720bd25551e2389925ef003c494fe","url":"https://img.federalregister.gov/ER04NO22.019/ER04NO22.019_medium.png","height":705},"original_size":{"identifier":"ER04NO22.019","content_type":"image/png","size":170265,"width":4253,"sha":"d1bcb9e3e4e6407be5075f6285f450e1","url":"https://img.federalregister.gov/ER04NO22.019/ER04NO22.019_original_size.png","height":5328}},"ER04NO22.018":{"large":{"identifier":"ER04NO22.018","content_type":"image/png","size":90497,"width":823,"sha":"555f8c9237d1bfb065967edc007e8a3a","url":"https://img.federalregister.gov/ER04NO22.018/ER04NO22.018_large.png","height":1071},"medium":{"identifier":"ER04NO22.018","content_type":"image/png","size":45067,"width":541,"sha":"058e6a1971a3fc47d0037219f4d728d0","url":"https://img.federalregister.gov/ER04NO22.018/ER04NO22.018_medium.png","height":705},"original_size":{"identifier":"ER04NO22.018","content_type":"image/png","size":163471,"width":4092,"sha":"e0bf2e882b9ff2a69a3f10b378adf60c","url":"https://img.federalregister.gov/ER04NO22.018/ER04NO22.018_original_size.png","height":5328}},"ER04NO22.017":{"large":{"identifier":"ER04NO22.017","content_type":"image/png","size":89993,"width":823,"sha":"e0b733a15afe0d7f400773a14bac6a82","url":"https://img.federalregister.gov/ER04NO22.017/ER04NO22.017_large.png","height":1075},"medium":{"identifier":"ER04NO22.017","content_type":"image/png","size":46189,"width":540,"sha":"03965c7290a2fdd2a64a57bd1ad036d5","url":"https://img.federalregister.gov/ER04NO22.017/ER04NO22.017_medium.png","height":706},"original_size":{"identifier":"ER04NO22.017","content_type":"image/png","size":158775,"width":4078,"sha":"8b517c7cddbe077252ce05f930fc14dc","url":"https://img.federalregister.gov/ER04NO22.017/ER04NO22.017_original_size.png","height":5328}},"ER04NO22.016":{"large":{"identifier":"ER04NO22.016","content_type":"image/png","size":75148,"width":823,"sha":"200efc9333dee87290928177d2c7fed3","url":"https://img.federalregister.gov/ER04NO22.016/ER04NO22.016_large.png","height":893},"medium":{"identifier":"ER04NO22.016","content_type":"image/png","size":39435,"width":574,"sha":"3338122ce023b595ef900b150363b416","url":"https://img.federalregister.gov/ER04NO22.016/ER04NO22.016_medium.png","height":623},"original_size":{"identifier":"ER04NO22.016","content_type":"image/png","size":146667,"width":4333,"sha":"b84c1f779f5397e7beed672afecad3ee","url":"https://img.federalregister.gov/ER04NO22.016/ER04NO22.016_original_size.png","height":4701}},"ER04NO22.015":{"large":{"identifier":"ER04NO22.015","content_type":"image/png","size":64531,"width":823,"sha":"594b7d26c3bb775a9b33fc955ee8a5eb","url":"https://img.federalregister.gov/ER04NO22.015/ER04NO22.015_large.png","height":622},"medium":{"identifier":"ER04NO22.015","content_type":"image/png","size":37491,"width":573,"sha":"d33af218306803872582a43975ac0294","url":"https://img.federalregister.gov/ER04NO22.015/ER04NO22.015_medium.png","height":433},"original_size":{"identifier":"ER04NO22.015","content_type":"image/png","size":140894,"width":4389,"sha":"9eb0ecb2a8b82086952449bfc33976d4","url":"https://img.federalregister.gov/ER04NO22.015/ER04NO22.015_original_size.png","height":3318}},"ER04NO22.014":{"large":{"identifier":"ER04NO22.014","content_type":"image/png","size":14945,"width":823,"sha":"02ea2092d1eefd8871e83f9d3fd9afaf","url":"https://img.federalregister.gov/ER04NO22.014/ER04NO22.014_large.png","height":233},"medium":{"identifier":"ER04NO22.014","content_type":"image/png","size":7579,"width":492,"sha":"027fe62189f9e5732550069a93cc8567","url":"https://img.federalregister.gov/ER04NO22.014/ER04NO22.014_medium.png","height":139},"original_size":{"identifier":"ER04NO22.014","content_type":"image/png","size":22517,"width":3719,"sha":"7286dead3bf3ed752a436fee60d16207","url":"https://img.federalregister.gov/ER04NO22.014/ER04NO22.014_original_size.png","height":1051}},"ER04NO22.058":{"large":{"identifier":"ER04NO22.058","content_type":"image/png","size":46090,"width":822,"sha":"f745e3c222aa2b3121b10b38705edd79","url":"https://img.federalregister.gov/ER04NO22.058/ER04NO22.058_large.png","height":343},"medium":{"identifier":"ER04NO22.058","content_type":"image/png","size":23303,"width":515,"sha":"54a1e8191d089feb4a19368571a0a0ad","url":"https://img.federalregister.gov/ER04NO22.058/ER04NO22.058_medium.png","height":215},"original_size":{"identifier":"ER04NO22.058","content_type":"image/png","size":92671,"width":3900,"sha":"c7b6c2835ba2b19329ed897a9aa2c85a","url":"https://img.federalregister.gov/ER04NO22.058/ER04NO22.058_original_size.png","height":1628}},"ER04NO22.013":{"large":{"identifier":"ER04NO22.013","content_type":"image/png","size":45559,"width":823,"sha":"f13fb22b9b044b6096b152ce0731cddc","url":"https://img.federalregister.gov/ER04NO22.013/ER04NO22.013_large.png","height":969},"medium":{"identifier":"ER04NO22.013","content_type":"image/png","size":26382,"width":492,"sha":"959a6f07b12cb0dd1a835708e3c731ba","url":"https://img.federalregister.gov/ER04NO22.013/ER04NO22.013_medium.png","height":579},"original_size":{"identifier":"ER04NO22.013","content_type":"image/png","size":60946,"width":3719,"sha":"a5a230639d57eec919156171a0a4fee4","url":"https://img.federalregister.gov/ER04NO22.013/ER04NO22.013_original_size.png","height":4380}},"ER04NO22.057":{"large":{"identifier":"ER04NO22.057","content_type":"image/png","size":11280,"width":822,"sha":"76c2b6fbff0293bda70b11a21e20c660","url":"https://img.federalregister.gov/ER04NO22.057/ER04NO22.057_large.png","height":91},"medium":{"identifier":"ER04NO22.057","content_type":"image/png","size":4935,"width":470,"sha":"2a4dd4208d04f0ddb4d61454ac31adb7","url":"https://img.federalregister.gov/ER04NO22.057/ER04NO22.057_medium.png","height":52},"original_size":{"identifier":"ER04NO22.057","content_type":"image/png","size":19399,"width":3561,"sha":"23733bdd087e7c3ea8e16b52f7fd4dad","url":"https://img.federalregister.gov/ER04NO22.057/ER04NO22.057_original_size.png","height":394}},"ER04NO22.012":{"large":{"identifier":"ER04NO22.012","content_type":"image/png","size":19727,"width":823,"sha":"a023602b283d90798d4b2fd96b52b3a2","url":"https://img.federalregister.gov/ER04NO22.012/ER04NO22.012_large.png","height":205},"medium":{"identifier":"ER04NO22.012","content_type":"image/png","size":10526,"width":514,"sha":"febe44690c6d595653a322b8af7ddb37","url":"https://img.federalregister.gov/ER04NO22.012/ER04NO22.012_medium.png","height":128},"original_size":{"identifier":"ER04NO22.012","content_type":"image/png","size":40095,"width":3880,"sha":"727eab409b99353c54195987c34e27ff","url":"https://img.federalregister.gov/ER04NO22.012/ER04NO22.012_original_size.png","height":965}},"ER04NO22.056":{"large":{"identifier":"ER04NO22.056","content_type":"image/png","size":4992,"width":823,"sha":"55b67c2b1fae3b536e12771f9cdfc2d8","url":"https://img.federalregister.gov/ER04NO22.056/ER04NO22.056_large.png","height":49},"medium":{"identifier":"ER04NO22.056","content_type":"image/png","size":2673,"width":532,"sha":"47338878851c36a7fe946c4e7222c196","url":"https://img.federalregister.gov/ER04NO22.056/ER04NO22.056_medium.png","height":32},"original_size":{"identifier":"ER04NO22.056","content_type":"image/png","size":9687,"width":4013,"sha":"4847a528830d189fd93ec8c8d17a145c","url":"https://img.federalregister.gov/ER04NO22.056/ER04NO22.056_original_size.png","height":238}},"ER04NO22.011":{"large":{"identifier":"ER04NO22.011","content_type":"image/png","size":70090,"width":823,"sha":"f8a6a2181f10e4d046f1a5be7bd1226c","url":"https://img.federalregister.gov/ER04NO22.011/ER04NO22.011_large.png","height":1129},"medium":{"identifier":"ER04NO22.011","content_type":"image/png","size":38016,"width":514,"sha":"dd4e78a0905967394199dbd748bdf81a","url":"https://img.federalregister.gov/ER04NO22.011/ER04NO22.011_medium.png","height":705},"original_size":{"identifier":"ER04NO22.011","content_type":"image/png","size":112992,"width":3880,"sha":"9c582281a5c78e459496dc815d43779d","url":"https://img.federalregister.gov/ER04NO22.011/ER04NO22.011_original_size.png","height":5323}},"ER04NO22.055":{"large":{"identifier":"ER04NO22.055","content_type":"image/png","size":7622,"width":811,"sha":"a605dd0b94be095efb950890d19c28cd","url":"https://img.federalregister.gov/ER04NO22.055/ER04NO22.055_large.png","height":91},"medium":{"identifier":"ER04NO22.055","content_type":"image/png","size":3287,"width":419,"sha":"4aacaca9d1047ab08b275d39a776823c","url":"https://img.federalregister.gov/ER04NO22.055/ER04NO22.055_medium.png","height":47},"original_size":{"identifier":"ER04NO22.055","content_type":"image/png","size":10803,"width":3228,"sha":"08f72de79f95afe8c0cb9d17b36ef1a9","url":"https://img.federalregister.gov/ER04NO22.055/ER04NO22.055_original_size.png","height":362}},"ER04NO22.010":{"large":{"identifier":"ER04NO22.010","content_type":"image/png","size":33264,"width":822,"sha":"7bc77d1868b2c2e7e28896324011684c","url":"https://img.federalregister.gov/ER04NO22.010/ER04NO22.010_large.png","height":357},"medium":{"identifier":"ER04NO22.010","content_type":"image/png","size":19335,"width":546,"sha":"87e45117c0283c7471c491d42b6528b9","url":"https://img.federalregister.gov/ER04NO22.010/ER04NO22.010_medium.png","height":237},"original_size":{"identifier":"ER04NO22.010","content_type":"image/png","size":68841,"width":4128,"sha":"5e80d8993fa44e350f6431e636493e8c","url":"https://img.federalregister.gov/ER04NO22.010/ER04NO22.010_original_size.png","height":1793}},"ER04NO22.054":{"large":{"identifier":"ER04NO22.054","content_type":"image/png","size":43722,"width":823,"sha":"a0233f443bb0dac73297c6296903b490","url":"https://img.federalregister.gov/ER04NO22.054/ER04NO22.054_large.png","height":364},"medium":{"identifier":"ER04NO22.054","content_type":"image/png","size":18889,"width":511,"sha":"f5bdae056c43953c6cc3dd5243883e70","url":"https://img.federalregister.gov/ER04NO22.054/ER04NO22.054_medium.png","height":226},"original_size":{"identifier":"ER04NO22.054","content_type":"image/png","size":80290,"width":3858,"sha":"5ee30115b962597f308775a7f17061d5","url":"https://img.federalregister.gov/ER04NO22.054/ER04NO22.054_original_size.png","height":1705}},"ER04NO22.053":{"large":{"identifier":"ER04NO22.053","content_type":"image/png","size":112879,"width":823,"sha":"9c5c24122b93d33b2bd849c4f5590f1d","url":"https://img.federalregister.gov/ER04NO22.053/ER04NO22.053_large.png","height":963},"medium":{"identifier":"ER04NO22.053","content_type":"image/png","size":61054,"width":574,"sha":"ce8411df4787c8e885abfab3e3c09153","url":"https://img.federalregister.gov/ER04NO22.053/ER04NO22.053_medium.png","height":672},"original_size":{"identifier":"ER04NO22.053","content_type":"image/png","size":250570,"width":4556,"sha":"022ae51cf43bbdf2b4eb7813218b713d","url":"https://img.federalregister.gov/ER04NO22.053/ER04NO22.053_original_size.png","height":5333}},"ER04NO22.052":{"large":{"identifier":"ER04NO22.052","content_type":"image/png","size":31570,"width":821,"sha":"4cd59f94c253f823062a7cbebe8fbc3e","url":"https://img.federalregister.gov/ER04NO22.052/ER04NO22.052_large.png","height":283},"medium":{"identifier":"ER04NO22.052","content_type":"image/png","size":14960,"width":516,"sha":"1ad1241b83637c1f2c10901a347671a1","url":"https://img.federalregister.gov/ER04NO22.052/ER04NO22.052_medium.png","height":178},"original_size":{"identifier":"ER04NO22.052","content_type":"image/png","size":60544,"width":3898,"sha":"5cb61000d3dcc86cbb37570f04bed7cb","url":"https://img.federalregister.gov/ER04NO22.052/ER04NO22.052_original_size.png","height":1344}},"ER04NO22.051":{"large":{"identifier":"ER04NO22.051","content_type":"image/png","size":19016,"width":821,"sha":"691668b832b9074b8a4fcc58e7af4fd8","url":"https://img.federalregister.gov/ER04NO22.051/ER04NO22.051_large.png","height":206},"medium":{"identifier":"ER04NO22.051","content_type":"image/png","size":9720,"width":514,"sha":"c7716a8d0dca5356f572868a8807819d","url":"https://img.federalregister.gov/ER04NO22.051/ER04NO22.051_medium.png","height":129},"original_size":{"identifier":"ER04NO22.051","content_type":"image/png","size":32893,"width":3898,"sha":"13cc52d835e12e2cbaac9275acb6a541","url":"https://img.federalregister.gov/ER04NO22.051/ER04NO22.051_original_size.png","height":978}},"ER04NO22.050":{"large":{"identifier":"ER04NO22.050","content_type":"image/png","size":18355,"width":823,"sha":"d58a2aca235d460430b03dd6e1481903","url":"https://img.federalregister.gov/ER04NO22.050/ER04NO22.050_large.png","height":195},"medium":{"identifier":"ER04NO22.050","content_type":"image/png","size":11260,"width":574,"sha":"d8ec88daa946bee35be05cb219c92e6a","url":"https://img.federalregister.gov/ER04NO22.050/ER04NO22.050_medium.png","height":136},"original_size":{"identifier":"ER04NO22.050","content_type":"image/png","size":42449,"width":4615,"sha":"24d023d016c063924ceb397757501686","url":"https://img.federalregister.gov/ER04NO22.050/ER04NO22.050_original_size.png","height":1093}},"ER04NO22.029":{"large":{"identifier":"ER04NO22.029","content_type":"image/png","size":92121,"width":823,"sha":"d76d42c39d0ac547cb5696ceeb65e32c","url":"https://img.federalregister.gov/ER04NO22.029/ER04NO22.029_large.png","height":798},"medium":{"identifier":"ER04NO22.029","content_type":"image/png","size":56972,"width":574,"sha":"872350867fab626d44dbaa644974ece8","url":"https://img.federalregister.gov/ER04NO22.029/ER04NO22.029_medium.png","height":556},"original_size":{"identifier":"ER04NO22.029","content_type":"image/png","size":118630,"width":4376,"sha":"c404eb6e5860637cf198218d56c59595","url":"https://img.federalregister.gov/ER04NO22.029/ER04NO22.029_original_size.png","height":4241}},"ER04NO22.028":{"large":{"identifier":"ER04NO22.028","content_type":"image/png","size":93079,"width":823,"sha":"569617499c1ec227ecbc6d943263d7a9","url":"https://img.federalregister.gov/ER04NO22.028/ER04NO22.028_large.png","height":798},"medium":{"identifier":"ER04NO22.028","content_type":"image/png","size":57191,"width":574,"sha":"7687327e6e6f20fc459779c5afcc3067","url":"https://img.federalregister.gov/ER04NO22.028/ER04NO22.028_medium.png","height":556},"original_size":{"identifier":"ER04NO22.028","content_type":"image/png","size":116093,"width":4376,"sha":"359c33f398d3120b07be5e79e1b9a911","url":"https://img.federalregister.gov/ER04NO22.028/ER04NO22.028_original_size.png","height":4241}},"ER04NO22.027":{"large":{"identifier":"ER04NO22.027","content_type":"image/png","size":87156,"width":823,"sha":"f7c66cda09e48befbd0466f1cd053e58","url":"https://img.federalregister.gov/ER04NO22.027/ER04NO22.027_large.png","height":798},"medium":{"identifier":"ER04NO22.027","content_type":"image/png","size":55840,"width":574,"sha":"6ef70b7af211a3b5e3a357e1b8424217","url":"https://img.federalregister.gov/ER04NO22.027/ER04NO22.027_medium.png","height":556},"original_size":{"identifier":"ER04NO22.027","content_type":"image/png","size":119901,"width":4376,"sha":"f642c782f709ec48f83703bb77fd234a","url":"https://img.federalregister.gov/ER04NO22.027/ER04NO22.027_original_size.png","height":4241}},"ER04NO22.026":{"large":{"identifier":"ER04NO22.026","content_type":"image/png","size":81174,"width":823,"sha":"2de634591af94febba96952d4149ef93","url":"https://img.federalregister.gov/ER04NO22.026/ER04NO22.026_large.png","height":798},"medium":{"identifier":"ER04NO22.026","content_type":"image/png","size":52479,"width":574,"sha":"23555d2b74c3755a5720fbcea513347a","url":"https://img.federalregister.gov/ER04NO22.026/ER04NO22.026_medium.png","height":556},"original_size":{"identifier":"ER04NO22.026","content_type":"image/png","size":122078,"width":4376,"sha":"a081f6aa44df60e77df0ce0c0da595a5","url":"https://img.federalregister.gov/ER04NO22.026/ER04NO22.026_original_size.png","height":4241}},"ER04NO22.025":{"large":{"identifier":"ER04NO22.025","content_type":"image/png","size":108012,"width":823,"sha":"3013f0e4373ddaacae74a902fe42a388","url":"https://img.federalregister.gov/ER04NO22.025/ER04NO22.025_large.png","height":906},"medium":{"identifier":"ER04NO22.025","content_type":"image/png","size":47392,"width":510,"sha":"b67da263104a186ebe3b23e6e59eb226","url":"https://img.federalregister.gov/ER04NO22.025/ER04NO22.025_medium.png","height":561},"original_size":{"identifier":"ER04NO22.025","content_type":"image/png","size":120745,"width":3853,"sha":"bd487b688b22de737d851777796bb063","url":"https://img.federalregister.gov/ER04NO22.025/ER04NO22.025_original_size.png","height":4241}},"ER04NO22.024":{"large":{"identifier":"ER04NO22.024","content_type":"image/png","size":58548,"width":823,"sha":"6ec83e02be6711740368ba0fd49c4eeb","url":"https://img.federalregister.gov/ER04NO22.024/ER04NO22.024_large.png","height":635},"medium":{"identifier":"ER04NO22.024","content_type":"image/png","size":34070,"width":561,"sha":"2a349c21d94da0d42119d61158dd0a65","url":"https://img.federalregister.gov/ER04NO22.024/ER04NO22.024_medium.png","height":433},"original_size":{"identifier":"ER04NO22.024","content_type":"image/png","size":112383,"width":4232,"sha":"59d3e60c86f0bc478b38550451d51188","url":"https://img.federalregister.gov/ER04NO22.024/ER04NO22.024_original_size.png","height":3265}},"ER04NO22.023":{"large":{"identifier":"ER04NO22.023","content_type":"image/png","size":88719,"width":823,"sha":"49cc15472225816564bf051b7ed76bf9","url":"https://img.federalregister.gov/ER04NO22.023/ER04NO22.023_large.png","height":1061},"medium":{"identifier":"ER04NO22.023","content_type":"image/png","size":47494,"width":546,"sha":"697ced694771c1e327225bc25d02f2dd","url":"https://img.federalregister.gov/ER04NO22.023/ER04NO22.023_medium.png","height":704},"original_size":{"identifier":"ER04NO22.023","content_type":"image/png","size":160513,"width":4129,"sha":"675841ed87303dd87e4312c971bbdd98","url":"https://img.federalregister.gov/ER04NO22.023/ER04NO22.023_original_size.png","height":5323}},"ER04NO22.022":{"large":{"identifier":"ER04NO22.022","content_type":"image/png","size":42551,"width":823,"sha":"5812fa9c29c234e0055cdf89cabf22d9","url":"https://img.federalregister.gov/ER04NO22.022/ER04NO22.022_large.png","height":533},"medium":{"identifier":"ER04NO22.022","content_type":"image/png","size":25416,"width":574,"sha":"84e5cfcf71decf55c6133fdd1d8a58b8","url":"https://img.federalregister.gov/ER04NO22.022/ER04NO22.022_medium.png","height":372},"original_size":{"identifier":"ER04NO22.022","content_type":"image/png","size":98267,"width":4333,"sha":"230522c6862315c6b58cba30c360a175","url":"https://img.federalregister.gov/ER04NO22.022/ER04NO22.022_original_size.png","height":2807}},"ER04NO22.021":{"large":{"identifier":"ER04NO22.021","content_type":"image/png","size":93194,"width":823,"sha":"8a4b38cbc9404a3ae1880f58917d0f5d","url":"https://img.federalregister.gov/ER04NO22.021/ER04NO22.021_large.png","height":1089},"medium":{"identifier":"ER04NO22.021","content_type":"image/png","size":46002,"width":533,"sha":"1cc748428d9a6f52c9330f87181fc164","url":"https://img.federalregister.gov/ER04NO22.021/ER04NO22.021_medium.png","height":705},"original_size":{"identifier":"ER04NO22.021","content_type":"image/png","size":159073,"width":4028,"sha":"1574c1dba6f380ee929edf32891aa33e","url":"https://img.federalregister.gov/ER04NO22.021/ER04NO22.021_original_size.png","height":5328}},"ER04NO22.020":{"large":{"identifier":"ER04NO22.020","content_type":"image/png","size":91715,"width":822,"sha":"1c1e7e3cfb937e41d39c118cd697d364","url":"https://img.federalregister.gov/ER04NO22.020/ER04NO22.020_large.png","height":1093},"medium":{"identifier":"ER04NO22.020","content_type":"image/png","size":43006,"width":530,"sha":"9bef9ea7f864a2f07de7cb834e24b3ff","url":"https://img.federalregister.gov/ER04NO22.020/ER04NO22.020_medium.png","height":705},"original_size":{"identifier":"ER04NO22.020","content_type":"image/png","size":154985,"width":4006,"sha":"871e806813ae7ee443aef25bfb92d24d","url":"https://img.federalregister.gov/ER04NO22.020/ER04NO22.020_original_size.png","height":5328}},"ER04NO22.039":{"large":{"identifier":"ER04NO22.039","content_type":"image/png","size":17759,"width":823,"sha":"0f5dfa9662cc37cefe660642ff1b398b","url":"https://img.federalregister.gov/ER04NO22.039/ER04NO22.039_large.png","height":165},"medium":{"identifier":"ER04NO22.039","content_type":"image/png","size":8807,"width":510,"sha":"59f43034461a634432d1287947e5a277","url":"https://img.federalregister.gov/ER04NO22.039/ER04NO22.039_medium.png","height":102},"original_size":{"identifier":"ER04NO22.039","content_type":"image/png","size":29443,"width":3850,"sha":"df534076c29576c53aac4a9e99b2e83c","url":"https://img.federalregister.gov/ER04NO22.039/ER04NO22.039_original_size.png","height":771}},"ER04NO22.038":{"large":{"identifier":"ER04NO22.038","content_type":"image/png","size":78939,"width":590,"sha":"c60671e9a1dfb268ac192241bcfe6640","url":"https://img.federalregister.gov/ER04NO22.038/ER04NO22.038_large.png","height":1271},"medium":{"identifier":"ER04NO22.038","content_type":"image/png","size":27272,"width":278,"sha":"117f07da35c48bfb91cba81d9cbeefbc","url":"https://img.federalregister.gov/ER04NO22.038/ER04NO22.038_medium.png","height":598},"original_size":{"identifier":"ER04NO22.038","content_type":"image/png","size":68902,"width":2096,"sha":"766718114a67d6070818b19723fd0e3d","url":"https://img.federalregister.gov/ER04NO22.038/ER04NO22.038_original_size.png","height":4516}},"ER04NO22.037":{"large":{"identifier":"ER04NO22.037","content_type":"image/png","size":84592,"width":823,"sha":"9f17a80927b2bdd970d49ce8869cffe9","url":"https://img.federalregister.gov/ER04NO22.037/ER04NO22.037_large.png","height":798},"medium":{"identifier":"ER04NO22.037","content_type":"image/png","size":48612,"width":574,"sha":"c1a71691cd5ac6212d850416b844dab5","url":"https://img.federalregister.gov/ER04NO22.037/ER04NO22.037_medium.png","height":556},"original_size":{"identifier":"ER04NO22.037","content_type":"image/png","size":110287,"width":4376,"sha":"d1f223d8287e68775cf60851302bfe42","url":"https://img.federalregister.gov/ER04NO22.037/ER04NO22.037_original_size.png","height":4241}},"ER04NO22.036":{"large":{"identifier":"ER04NO22.036","content_type":"image/png","size":86078,"width":823,"sha":"08719028b494e02d6a28800829b8956b","url":"https://img.federalregister.gov/ER04NO22.036/ER04NO22.036_large.png","height":798},"medium":{"identifier":"ER04NO22.036","content_type":"image/png","size":49809,"width":574,"sha":"b193998d60698a1e0f0d0d657b30b359","url":"https://img.federalregister.gov/ER04NO22.036/ER04NO22.036_medium.png","height":556},"original_size":{"identifier":"ER04NO22.036","content_type":"image/png","size":113224,"width":4376,"sha":"09d0fc54a63da8a97cc0542fc895efe4","url":"https://img.federalregister.gov/ER04NO22.036/ER04NO22.036_original_size.png","height":4241}},"ER04NO22.035":{"large":{"identifier":"ER04NO22.035","content_type":"image/png","size":85864,"width":823,"sha":"94b821b19f9dcab976d50e53070d128c","url":"https://img.federalregister.gov/ER04NO22.035/ER04NO22.035_large.png","height":820},"medium":{"identifier":"ER04NO22.035","content_type":"image/png","size":50012,"width":564,"sha":"9809bd627527d00050c7a52938e133e5","url":"https://img.federalregister.gov/ER04NO22.035/ER04NO22.035_medium.png","height":562},"original_size":{"identifier":"ER04NO22.035","content_type":"image/png","size":135076,"width":4255,"sha":"75b211ba09a55466da693c9aa178140a","url":"https://img.federalregister.gov/ER04NO22.035/ER04NO22.035_original_size.png","height":4241}},"ER04NO22.034":{"large":{"identifier":"ER04NO22.034","content_type":"image/png","size":75110,"width":823,"sha":"e967d203eda8702843f6bc3379ab53c8","url":"https://img.federalregister.gov/ER04NO22.034/ER04NO22.034_large.png","height":812},"medium":{"identifier":"ER04NO22.034","content_type":"image/png","size":36989,"width":570,"sha":"bf64590a930d6429d471206a4f72842b","url":"https://img.federalregister.gov/ER04NO22.034/ER04NO22.034_medium.png","height":562},"original_size":{"identifier":"ER04NO22.034","content_type":"image/png","size":102263,"width":4300,"sha":"7fb5cf0091be08cfee5f70fefdb5904d","url":"https://img.federalregister.gov/ER04NO22.034/ER04NO22.034_original_size.png","height":4241}},"ER04NO22.033":{"large":{"identifier":"ER04NO22.033","content_type":"image/png","size":85072,"width":823,"sha":"77acab079b6387f74e2e6c0da3aeed3b","url":"https://img.federalregister.gov/ER04NO22.033/ER04NO22.033_large.png","height":810},"medium":{"identifier":"ER04NO22.033","content_type":"image/png","size":52174,"width":571,"sha":"17abe618886cabad8c1c19429c52a10d","url":"https://img.federalregister.gov/ER04NO22.033/ER04NO22.033_medium.png","height":562},"original_size":{"identifier":"ER04NO22.033","content_type":"image/png","size":142750,"width":4310,"sha":"cfdb37a0839c9f7b864f8db58073b324","url":"https://img.federalregister.gov/ER04NO22.033/ER04NO22.033_original_size.png","height":4241}},"ER04NO22.032":{"large":{"identifier":"ER04NO22.032","content_type":"image/png","size":87728,"width":823,"sha":"55fcbe2cba2fa52678ca6088d9c910df","url":"https://img.federalregister.gov/ER04NO22.032/ER04NO22.032_large.png","height":798},"medium":{"identifier":"ER04NO22.032","content_type":"image/png","size":59234,"width":574,"sha":"581140b64b6f48ae015a77423e647d8d","url":"https://img.federalregister.gov/ER04NO22.032/ER04NO22.032_medium.png","height":556},"original_size":{"identifier":"ER04NO22.032","content_type":"image/png","size":120922,"width":4376,"sha":"e7cdc1a531f88d0b143f35b499d51dff","url":"https://img.federalregister.gov/ER04NO22.032/ER04NO22.032_original_size.png","height":4241}},"ER04NO22.031":{"large":{"identifier":"ER04NO22.031","content_type":"image/png","size":85136,"width":823,"sha":"188e7efc97b6dd61c4793901ab4f808a","url":"https://img.federalregister.gov/ER04NO22.031/ER04NO22.031_large.png","height":798},"medium":{"identifier":"ER04NO22.031","content_type":"image/png","size":57467,"width":574,"sha":"fa438196a63be83f25d270895c944abe","url":"https://img.federalregister.gov/ER04NO22.031/ER04NO22.031_medium.png","height":556},"original_size":{"identifier":"ER04NO22.031","content_type":"image/png","size":122969,"width":4376,"sha":"8720591cb98a42210731c1b70d351a88","url":"https://img.federalregister.gov/ER04NO22.031/ER04NO22.031_original_size.png","height":4241}},"ER04NO22.030":{"large":{"identifier":"ER04NO22.030","content_type":"image/png","size":90856,"width":823,"sha":"1df653a9cd7755e8493aa92849d4e855","url":"https://img.federalregister.gov/ER04NO22.030/ER04NO22.030_large.png","height":798},"medium":{"identifier":"ER04NO22.030","content_type":"image/png","size":59535,"width":574,"sha":"370929331a68dc649f11cd3102aeb971","url":"https://img.federalregister.gov/ER04NO22.030/ER04NO22.030_medium.png","height":556},"original_size":{"identifier":"ER04NO22.030","content_type":"image/png","size":120627,"width":4376,"sha":"541b20b39df8d6811edc586411d3d914","url":"https://img.federalregister.gov/ER04NO22.030/ER04NO22.030_original_size.png","height":4241}},"ER04NO22.009":{"large":{"identifier":"ER04NO22.009","content_type":"image/png","size":12496,"width":823,"sha":"7adca641ab8063a93080f6babfdb95e4","url":"https://img.federalregister.gov/ER04NO22.009/ER04NO22.009_large.png","height":120},"medium":{"identifier":"ER04NO22.009","content_type":"image/png","size":6737,"width":541,"sha":"86a763ce98269051d3bfe39c0a773b31","url":"https://img.federalregister.gov/ER04NO22.009/ER04NO22.009_medium.png","height":79},"original_size":{"identifier":"ER04NO22.009","content_type":"image/png","size":23359,"width":4091,"sha":"c7373b6f3f40abc4524c972d61767b6f","url":"https://img.federalregister.gov/ER04NO22.009/ER04NO22.009_original_size.png","height":597}},"ER04NO22.008":{"large":{"identifier":"ER04NO22.008","content_type":"image/png","size":34606,"width":823,"sha":"b949e27f1efa353c3d48327ce49f4199","url":"https://img.federalregister.gov/ER04NO22.008/ER04NO22.008_large.png","height":281},"medium":{"identifier":"ER04NO22.008","content_type":"image/png","size":18349,"width":574,"sha":"e78b93ca9d41d533602f5cf5479caa66","url":"https://img.federalregister.gov/ER04NO22.008/ER04NO22.008_medium.png","height":196},"original_size":{"identifier":"ER04NO22.008","content_type":"image/png","size":76637,"width":4392,"sha":"612dfdce4b9b937b5fc1c1169c65e539","url":"https://img.federalregister.gov/ER04NO22.008/ER04NO22.008_original_size.png","height":1497}},"ER04NO22.007":{"large":{"identifier":"ER04NO22.007","content_type":"image/png","size":21023,"width":823,"sha":"a27f2e9378315bb805753b8a5ed31f9b","url":"https://img.federalregister.gov/ER04NO22.007/ER04NO22.007_large.png","height":273},"medium":{"identifier":"ER04NO22.007","content_type":"image/png","size":10566,"width":516,"sha":"642a6e0236fa6ec82272f46a0e01572b","url":"https://img.federalregister.gov/ER04NO22.007/ER04NO22.007_medium.png","height":171},"original_size":{"identifier":"ER04NO22.007","content_type":"image/png","size":32072,"width":3901,"sha":"57124d1783540c5716b184d50948448e","url":"https://img.federalregister.gov/ER04NO22.007/ER04NO22.007_original_size.png","height":1292}},"ER04NO22.006":{"large":{"identifier":"ER04NO22.006","content_type":"image/png","size":12345,"width":817,"sha":"b29e7b0fa3361702789a34f893cf30dd","url":"https://img.federalregister.gov/ER04NO22.006/ER04NO22.006_large.png","height":112},"medium":{"identifier":"ER04NO22.006","content_type":"image/png","size":6685,"width":569,"sha":"208760b128f81c259c73d480a2a07f23","url":"https://img.federalregister.gov/ER04NO22.006/ER04NO22.006_medium.png","height":78},"original_size":{"identifier":"ER04NO22.006","content_type":"image/png","size":24726,"width":4467,"sha":"40c85a0c71b123f37d71b187c935220a","url":"https://img.federalregister.gov/ER04NO22.006/ER04NO22.006_original_size.png","height":612}},"ER04NO22.005":{"large":{"identifier":"ER04NO22.005","content_type":"image/png","size":17311,"width":822,"sha":"aab8d415f9f0b366b78a02dd6eec1985","url":"https://img.federalregister.gov/ER04NO22.005/ER04NO22.005_large.png","height":139},"medium":{"identifier":"ER04NO22.005","content_type":"image/png","size":8538,"width":515,"sha":"8de42cea387157ef83eecd955cffa248","url":"https://img.federalregister.gov/ER04NO22.005/ER04NO22.005_medium.png","height":87},"original_size":{"identifier":"ER04NO22.005","content_type":"image/png","size":32270,"width":3898,"sha":"d495b63cc11dcbecbedc997e2b77e1ac","url":"https://img.federalregister.gov/ER04NO22.005/ER04NO22.005_original_size.png","height":659}},"ER04NO22.049":{"large":{"identifier":"ER04NO22.049","content_type":"image/png","size":13770,"width":822,"sha":"4ca437dfd1689fd98bc064df7bd84a4d","url":"https://img.federalregister.gov/ER04NO22.049/ER04NO22.049_large.png","height":136},"medium":{"identifier":"ER04NO22.049","content_type":"image/png","size":8218,"width":574,"sha":"d4f342d005e5137edf1554096bce7cf3","url":"https://img.federalregister.gov/ER04NO22.049/ER04NO22.049_medium.png","height":95},"original_size":{"identifier":"ER04NO22.049","content_type":"image/png","size":30436,"width":4353,"sha":"41e74aaae71d1bd7684dd91d90863cb5","url":"https://img.federalregister.gov/ER04NO22.049/ER04NO22.049_original_size.png","height":720}},"ER04NO22.004":{"large":{"identifier":"ER04NO22.004","content_type":"image/png","size":13636,"width":823,"sha":"37b6371bac5c7faccd5dbc41e60f83af","url":"https://img.federalregister.gov/ER04NO22.004/ER04NO22.004_large.png","height":118},"medium":{"identifier":"ER04NO22.004","content_type":"image/png","size":6707,"width":517,"sha":"5c61495f6410f91cc4e64b7aa3b818f5","url":"https://img.federalregister.gov/ER04NO22.004/ER04NO22.004_medium.png","height":74},"original_size":{"identifier":"ER04NO22.004","content_type":"image/png","size":25435,"width":3898,"sha":"be8b845286fbb749aeac05f300d725c1","url":"https://img.federalregister.gov/ER04NO22.004/ER04NO22.004_original_size.png","height":558}},"ER04NO22.048":{"large":{"identifier":"ER04NO22.048","content_type":"image/png","size":14742,"width":822,"sha":"dddc601d0f973903b8aab41767d74f7f","url":"https://img.federalregister.gov/ER04NO22.048/ER04NO22.048_large.png","height":148},"medium":{"identifier":"ER04NO22.048","content_type":"image/png","size":8232,"width":527,"sha":"a636fbc342dfaa94411014a367353c5f","url":"https://img.federalregister.gov/ER04NO22.048/ER04NO22.048_medium.png","height":95},"original_size":{"identifier":"ER04NO22.048","content_type":"image/png","size":26770,"width":3978,"sha":"a12ad3ad0cc423ccda6dfa1156e10db7","url":"https://img.federalregister.gov/ER04NO22.048/ER04NO22.048_original_size.png","height":716}},"ER04NO22.003":{"large":{"identifier":"ER04NO22.003","content_type":"image/png","size":24075,"width":823,"sha":"54dacb71ed9f94c3b3251450448e2d8a","url":"https://img.federalregister.gov/ER04NO22.003/ER04NO22.003_large.png","height":242},"medium":{"identifier":"ER04NO22.003","content_type":"image/png","size":12371,"width":517,"sha":"c1e5b56fd38d7e094b97a4fd8273d588","url":"https://img.federalregister.gov/ER04NO22.003/ER04NO22.003_medium.png","height":152},"original_size":{"identifier":"ER04NO22.003","content_type":"image/png","size":44195,"width":3901,"sha":"0db34a85f25557e3543070fa46b37eaf","url":"https://img.federalregister.gov/ER04NO22.003/ER04NO22.003_original_size.png","height":1148}},"ER04NO22.047":{"large":{"identifier":"ER04NO22.047","content_type":"image/png","size":60995,"width":823,"sha":"542a5dfec54a9a9500271605933e2058","url":"https://img.federalregister.gov/ER04NO22.047/ER04NO22.047_large.png","height":488},"medium":{"identifier":"ER04NO22.047","content_type":"image/png","size":27466,"width":511,"sha":"d184ed70bb833ca6d5be797dc6acd32d","url":"https://img.federalregister.gov/ER04NO22.047/ER04NO22.047_medium.png","height":303},"original_size":{"identifier":"ER04NO22.047","content_type":"image/png","size":184618,"width":3860,"sha":"aebffdb90485f238052e61180f52d739","url":"https://img.federalregister.gov/ER04NO22.047/ER04NO22.047_original_size.png","height":2291}},"ER04NO22.002":{"large":{"identifier":"ER04NO22.002","content_type":"image/png","size":21233,"width":819,"sha":"bb3797f599aca36b0fded709b433e646","url":"https://img.federalregister.gov/ER04NO22.002/ER04NO22.002_large.png","height":219},"medium":{"identifier":"ER04NO22.002","content_type":"image/png","size":10327,"width":546,"sha":"b010a294e79eae8d01cb2a13a0abb744","url":"https://img.federalregister.gov/ER04NO22.002/ER04NO22.002_medium.png","height":146},"original_size":{"identifier":"ER04NO22.002","content_type":"image/png","size":39207,"width":4128,"sha":"cf5bd833833ff3a074bc20488d53f291","url":"https://img.federalregister.gov/ER04NO22.002/ER04NO22.002_original_size.png","height":1104}},"ER04NO22.046":{"large":{"identifier":"ER04NO22.046","content_type":"image/png","size":40645,"width":822,"sha":"ab9e2898033d55b07cf85067bf3be167","url":"https://img.federalregister.gov/ER04NO22.046/ER04NO22.046_large.png","height":537},"medium":{"identifier":"ER04NO22.046","content_type":"image/png","size":20565,"width":517,"sha":"2de957b40d98187687bb226d92e49d6d","url":"https://img.federalregister.gov/ER04NO22.046/ER04NO22.046_medium.png","height":338},"original_size":{"identifier":"ER04NO22.046","content_type":"image/png","size":86286,"width":3906,"sha":"25e28ee36f191348ea63391a9a121913","url":"https://img.federalregister.gov/ER04NO22.046/ER04NO22.046_original_size.png","height":2552}},"ER04NO22.001":{"large":{"identifier":"ER04NO22.001","content_type":"image/png","size":69192,"width":823,"sha":"21a31daddfddf43895cfead0d97c6dc8","url":"https://img.federalregister.gov/ER04NO22.001/ER04NO22.001_large.png","height":979},"medium":{"identifier":"ER04NO22.001","content_type":"image/png","size":23918,"width":428,"sha":"4736952c56d2fb9b1cec45a59d325c32","url":"https://img.federalregister.gov/ER04NO22.001/ER04NO22.001_medium.png","height":509},"original_size":{"identifier":"ER04NO22.001","content_type":"image/png","size":281401,"width":3237,"sha":"c572d7591816cd318f1cf39ff367286c","url":"https://img.federalregister.gov/ER04NO22.001/ER04NO22.001_original_size.png","height":3849}},"ER04NO22.045":{"large":{"identifier":"ER04NO22.045","content_type":"image/png","size":41197,"width":823,"sha":"4c9224e97fc573489a79577379705e6a","url":"https://img.federalregister.gov/ER04NO22.045/ER04NO22.045_large.png","height":544},"medium":{"identifier":"ER04NO22.045","content_type":"image/png","size":21997,"width":518,"sha":"222302b78a5d06cc29f4fe66d652ca65","url":"https://img.federalregister.gov/ER04NO22.045/ER04NO22.045_medium.png","height":342},"original_size":{"identifier":"ER04NO22.045","content_type":"image/png","size":84800,"width":3906,"sha":"9dc95be66cf89715a63d61edb6dade52","url":"https://img.federalregister.gov/ER04NO22.045/ER04NO22.045_original_size.png","height":2581}},"ER04NO22.000":{"large":{"identifier":"ER04NO22.000","content_type":"image/png","size":52132,"width":823,"sha":"b32412e6863f0b7f5d5797bb68ec1fdc","url":"https://img.federalregister.gov/ER04NO22.000/ER04NO22.000_large.png","height":616},"medium":{"identifier":"ER04NO22.000","content_type":"image/png","size":25840,"width":574,"sha":"b062c94124960bfd371e46f47a9c4e13","url":"https://img.federalregister.gov/ER04NO22.000/ER04NO22.000_medium.png","height":430},"original_size":{"identifier":"ER04NO22.000","content_type":"image/png","size":112777,"width":4695,"sha":"71027af1eb8935a260c4bc6702982cf5","url":"https://img.federalregister.gov/ER04NO22.000/ER04NO22.000_original_size.png","height":3514}},"ER04NO22.044":{"large":{"identifier":"ER04NO22.044","content_type":"image/png","size":15735,"width":823,"sha":"3cf94d29570fea4edec3960a0c9db940","url":"https://img.federalregister.gov/ER04NO22.044/ER04NO22.044_large.png","height":154},"medium":{"identifier":"ER04NO22.044","content_type":"image/png","size":7900,"width":507,"sha":"f301cb06de58e5fea0fa393b75af1158","url":"https://img.federalregister.gov/ER04NO22.044/ER04NO22.044_medium.png","height":95},"original_size":{"identifier":"ER04NO22.044","content_type":"image/png","size":27298,"width":3828,"sha":"e48df396b69754c491f3637706135fbf","url":"https://img.federalregister.gov/ER04NO22.044/ER04NO22.044_original_size.png","height":715}},"ER04NO22.043":{"large":{"identifier":"ER04NO22.043","content_type":"image/png","size":165621,"width":807,"sha":"becea5dbc2fa8c9d497a634f2474a752","url":"https://img.federalregister.gov/ER04NO22.043/ER04NO22.043_large.png","height":1447},"medium":{"identifier":"ER04NO22.043","content_type":"image/png","size":49426,"width":380,"sha":"faf430e26304595ea18d489bcaaf7765","url":"https://img.federalregister.gov/ER04NO22.043/ER04NO22.043_medium.png","height":681},"original_size":{"identifier":"ER04NO22.043","content_type":"image/png","size":240745,"width":2870,"sha":"7dea7262af547cbfb122135a5c2c20a1","url":"https://img.federalregister.gov/ER04NO22.043/ER04NO22.043_original_size.png","height":5145}},"ER04NO22.042":{"large":{"identifier":"ER04NO22.042","content_type":"image/png","size":25942,"width":821,"sha":"f747923e683729997db658df62121eea","url":"https://img.federalregister.gov/ER04NO22.042/ER04NO22.042_large.png","height":327},"medium":{"identifier":"ER04NO22.042","content_type":"image/png","size":14199,"width":522,"sha":"4fa87b91ec1ac83223b43ac8f9ad9fd1","url":"https://img.federalregister.gov/ER04NO22.042/ER04NO22.042_medium.png","height":208},"original_size":{"identifier":"ER04NO22.042","content_type":"image/png","size":46364,"width":3955,"sha":"9c0eb88dadae7c94fe3c355bd449eb5b","url":"https://img.federalregister.gov/ER04NO22.042/ER04NO22.042_original_size.png","height":1576}},"ER04NO22.041":{"large":{"identifier":"ER04NO22.041","content_type":"image/png","size":27283,"width":823,"sha":"4d1073ed7571a0dd7e54a8ceae6267d5","url":"https://img.federalregister.gov/ER04NO22.041/ER04NO22.041_large.png","height":301},"medium":{"identifier":"ER04NO22.041","content_type":"image/png","size":13608,"width":520,"sha":"f0b3168e3a207e727c0e35f3b940f913","url":"https://img.federalregister.gov/ER04NO22.041/ER04NO22.041_medium.png","height":190},"original_size":{"identifier":"ER04NO22.041","content_type":"image/png","size":40426,"width":3925,"sha":"c8aec9cab37909e3cfc97b604c319933","url":"https://img.federalregister.gov/ER04NO22.041/ER04NO22.041_original_size.png","height":1434}},"ER04NO22.040":{"large":{"identifier":"ER04NO22.040","content_type":"image/png","size":18208,"width":823,"sha":"6cf2b2a5c3151fe5709ed4de80dd000e","url":"https://img.federalregister.gov/ER04NO22.040/ER04NO22.040_large.png","height":168},"medium":{"identifier":"ER04NO22.040","content_type":"image/png","size":9207,"width":518,"sha":"4542c4f364794eddd280c74f8b3f903f","url":"https://img.federalregister.gov/ER04NO22.040/ER04NO22.040_medium.png","height":106},"original_size":{"identifier":"ER04NO22.040","content_type":"image/png","size":31482,"width":3907,"sha":"bf8007014a9134f13fa57b2c57a5e653","url":"https://img.federalregister.gov/ER04NO22.040/ER04NO22.040_original_size.png","height":798}}},"json_url":"https://www.federalregister.gov/api/v1/documents/2022-23722?publication_date=2022-11-04","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2022-11-04/2022-23722/mods.xml","not_received_for_publication":null,"page_length":98,"page_views":{"count":18288,"last_updated":"2026-06-24 08:15:04 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2022-11-04/pdf/2022-23722.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2022-23722.pdf?1667247317","publication_date":"2022-11-04","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2022/11/04/2022-23722.txt","regulation_id_number_info":{"0938-AU77":{"issue":"202204","html_url":"https://www.federalregister.gov/regulations/0938-AU77/cy-2023-home-health-prospective-payment-system-rate-update-and-home-infusion-therapy-services-paymen","title":"CY 2023 Home Health Prospective Payment System Rate Update and Home Infusion Therapy Services Payment Update (CMS-1766)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=202204&RIN=0938-AU77&operation=OPERATION_EXPORT_XML","priority_category":"Economically Significant"}},"regulation_id_numbers":["0938-AU77"],"regulations_dot_gov_info":{"supporting_documents":[],"comments_count":0,"agency_id":"CMS","comments_url":"https://www.regulations.gov/docketBrowser?rpp=50&so=DESC&sb=postedDate&po=0&dct=PS&D=CMS-2022-0109","supporting_documents_count":0,"docket_id":"CMS-2022-0109","document_id":"CMS-2022-0109-0888","regulation_id_number":null,"title":"CY 2023 Home Health Prospective Payment System Rate Update and Home Infusion Therapy Services Payment Update (CMS-1766-P)","checked_regulationsdotgov_at":"2023-02-28T02:04:33Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":66790,"subtype":null,"title":"Medicare Program; Calendar Year (CY) 2023 Home Health Prospective Payment System Rate Update; Home Health Quality Reporting Program Requirements; Home Health Value-Based Purchasing Expanded Model Requirements; and Home Infusion Therapy Services Requirements","toc_doc":"Calendar Year 2023 Home Health Prospective Payment System Rate, Home Health Quality Reporting Program Requirements, etc.","toc_subject":"Medicare Program:\n","topics":["Health facilities","Health professions","Medicare","Reporting and recordkeeping requirements"],"type":"Rule","volume":87}