{"abstract":"This final rule will set forth the hospice wage index for fiscal year 2010. The final rule adopts a MedPAC recommendation regarding a process for certification and recertification of terminal illness. In addition, this final rule will also revise the phase-out of the wage index budget neutrality adjustment factor (BNAF), with a 10 percent BNAF reduction in FY 2010. The BNAF phase-out will continue with successive 15 percent reductions from FY 2011 through FY 2016.","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/2009/08/06/E9-18553.html","cfr_references":[{"chapter":null,"citation_url":null,"part":405,"title":42},{"chapter":null,"citation_url":null,"part":418,"title":42}],"citation":"74 FR 39384","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"Effective Date: These regulations are effective on October 1, 2009.","disposition_notes":null,"docket_ids":["CMS-1420-F"],"dockets":[],"document_number":"E9-18553","effective_on":"2009-10-01","end_page":39433,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2009/08/06/E9-18553.xml","html_url":"https://www.federalregister.gov/documents/2009/08/06/E9-18553/medicare-program-hospice-wage-index-for-fiscal-year-2010","images":{"ER06AU09.005":{"original_size":"https://img.federalregister.gov/ER06AU09.005/ER06AU09.005_original_size.gif"},"ER06AU09.016":{"large":"https://img.federalregister.gov/ER06AU09.016/ER06AU09.016_large.png","medium":"https://img.federalregister.gov/ER06AU09.016/ER06AU09.016_medium.png","original_size":"https://img.federalregister.gov/ER06AU09.016/ER06AU09.016_original_size.png"},"ER06AU09.004":{"original_size":"https://img.federalregister.gov/ER06AU09.004/ER06AU09.004_original_size.gif"},"ER06AU09.015":{"original_size":"https://img.federalregister.gov/ER06AU09.015/ER06AU09.015_original_size.gif"},"ER06AU09.003":{"original_size":"https://img.federalregister.gov/ER06AU09.003/ER06AU09.003_original_size.gif"},"ER06AU09.014":{"original_size":"https://img.federalregister.gov/ER06AU09.014/ER06AU09.014_original_size.gif"},"ER06AU09.002":{"original_size":"https://img.federalregister.gov/ER06AU09.002/ER06AU09.002_original_size.gif"},"ER06AU09.013":{"original_size":"https://img.federalregister.gov/ER06AU09.013/ER06AU09.013_original_size.gif"},"ER06AU09.001":{"original_size":"https://img.federalregister.gov/ER06AU09.001/ER06AU09.001_original_size.gif"},"ER06AU09.012":{"original_size":"https://img.federalregister.gov/ER06AU09.012/ER06AU09.012_original_size.gif"},"ER06AU09.000":{"original_size":"https://img.federalregister.gov/ER06AU09.000/ER06AU09.000_original_size.gif"},"ER06AU09.011":{"original_size":"https://img.federalregister.gov/ER06AU09.011/ER06AU09.011_original_size.gif"},"ER06AU09.010":{"original_size":"https://img.federalregister.gov/ER06AU09.010/ER06AU09.010_original_size.gif"},"ER06AU09.009":{"original_size":"https://img.federalregister.gov/ER06AU09.009/ER06AU09.009_original_size.gif"},"ER06AU09.008":{"original_size":"https://img.federalregister.gov/ER06AU09.008/ER06AU09.008_original_size.gif"},"ER06AU09.007":{"original_size":"https://img.federalregister.gov/ER06AU09.007/ER06AU09.007_original_size.gif"},"ER06AU09.018":{"original_size":"https://img.federalregister.gov/ER06AU09.018/ER06AU09.018_original_size.gif"},"ER06AU09.006":{"original_size":"https://img.federalregister.gov/ER06AU09.006/ER06AU09.006_original_size.gif"},"ER06AU09.017":{"original_size":"https://img.federalregister.gov/ER06AU09.017/ER06AU09.017_original_size.gif"}},"images_metadata":{"ER06AU09.005":{"original_size":{"identifier":"ER06AU09.005","content_type":"image/gif","size":279494,"width":2632,"sha":"371e899789cbbe4121b04354f05d1a9d","url":"https://img.federalregister.gov/ER06AU09.005/ER06AU09.005_original_size.gif","height":5117}},"ER06AU09.016":{"large":{"identifier":"ER06AU09.016","content_type":"image/png","size":97451,"width":749,"sha":"ef3ed8f5271b0dbe91c9d153a440b0b9","url":"https://img.federalregister.gov/ER06AU09.016/ER06AU09.016_large.png","height":1439},"medium":{"identifier":"ER06AU09.016","content_type":"image/png","size":30258,"width":352,"sha":"6ead6e51d31f5bf0632dbb7d38f2ff6c","url":"https://img.federalregister.gov/ER06AU09.016/ER06AU09.016_medium.png","height":677},"original_size":{"identifier":"ER06AU09.016","content_type":"image/png","size":1838578,"width":2664,"sha":"5e96ccdb7b4927324041d7fa9ee87402","url":"https://img.federalregister.gov/ER06AU09.016/ER06AU09.016_original_size.png","height":5117}},"ER06AU09.004":{"original_size":{"identifier":"ER06AU09.004","content_type":"image/gif","size":260617,"width":2634,"sha":"9140a5b9838a6b5a7a5d47a3ff4ee3f6","url":"https://img.federalregister.gov/ER06AU09.004/ER06AU09.004_original_size.gif","height":5113}},"ER06AU09.015":{"original_size":{"identifier":"ER06AU09.015","content_type":"image/gif","size":229143,"width":2464,"sha":"d4ecde659a2688486215cb8c3706af4b","url":"https://img.federalregister.gov/ER06AU09.015/ER06AU09.015_original_size.gif","height":5117}},"ER06AU09.003":{"original_size":{"identifier":"ER06AU09.003","content_type":"image/gif","size":217564,"width":2599,"sha":"8110394266171f34fffdedd2b8d3b40e","url":"https://img.federalregister.gov/ER06AU09.003/ER06AU09.003_original_size.gif","height":5119}},"ER06AU09.014":{"original_size":{"identifier":"ER06AU09.014","content_type":"image/gif","size":265898,"width":2621,"sha":"0418c4a0830db3be51bc87a8203f02d4","url":"https://img.federalregister.gov/ER06AU09.014/ER06AU09.014_original_size.gif","height":5117}},"ER06AU09.002":{"original_size":{"identifier":"ER06AU09.002","content_type":"image/gif","size":271605,"width":2481,"sha":"ad8792b9218e75deb9a2519f4cea34c2","url":"https://img.federalregister.gov/ER06AU09.002/ER06AU09.002_original_size.gif","height":5117}},"ER06AU09.013":{"original_size":{"identifier":"ER06AU09.013","content_type":"image/gif","size":155953,"width":2508,"sha":"7b43f23700966c407ad85edd05ba9121","url":"https://img.federalregister.gov/ER06AU09.013/ER06AU09.013_original_size.gif","height":5117}},"ER06AU09.001":{"original_size":{"identifier":"ER06AU09.001","content_type":"image/gif","size":233453,"width":2567,"sha":"f0cc62b69c4ecc479c11deb92c49504c","url":"https://img.federalregister.gov/ER06AU09.001/ER06AU09.001_original_size.gif","height":5121}},"ER06AU09.012":{"original_size":{"identifier":"ER06AU09.012","content_type":"image/gif","size":208769,"width":2404,"sha":"aa148167140ae8040ae5ebec41cbf660","url":"https://img.federalregister.gov/ER06AU09.012/ER06AU09.012_original_size.gif","height":5117}},"ER06AU09.000":{"original_size":{"identifier":"ER06AU09.000","content_type":"image/gif","size":215971,"width":2544,"sha":"0bd8c2562e2a80215e8b2974f5111324","url":"https://img.federalregister.gov/ER06AU09.000/ER06AU09.000_original_size.gif","height":5112}},"ER06AU09.011":{"original_size":{"identifier":"ER06AU09.011","content_type":"image/gif","size":279222,"width":2629,"sha":"2c983582c686cc5c08f5c211a14c3dc6","url":"https://img.federalregister.gov/ER06AU09.011/ER06AU09.011_original_size.gif","height":5117}},"ER06AU09.010":{"original_size":{"identifier":"ER06AU09.010","content_type":"image/gif","size":250392,"width":2622,"sha":"0016335a356bd7527dffa9ece518818b","url":"https://img.federalregister.gov/ER06AU09.010/ER06AU09.010_original_size.gif","height":5117}},"ER06AU09.009":{"original_size":{"identifier":"ER06AU09.009","content_type":"image/gif","size":270853,"width":2626,"sha":"46af312325645c2cad10d8c0e12ca650","url":"https://img.federalregister.gov/ER06AU09.009/ER06AU09.009_original_size.gif","height":5117}},"ER06AU09.008":{"original_size":{"identifier":"ER06AU09.008","content_type":"image/gif","size":250931,"width":2455,"sha":"afb4ed414bfaec6c901272f3de6bfb7a","url":"https://img.federalregister.gov/ER06AU09.008/ER06AU09.008_original_size.gif","height":5117}},"ER06AU09.007":{"original_size":{"identifier":"ER06AU09.007","content_type":"image/gif","size":241780,"width":2609,"sha":"0d2f874fab4f4cd535d3b6049a2fb111","url":"https://img.federalregister.gov/ER06AU09.007/ER06AU09.007_original_size.gif","height":5117}},"ER06AU09.018":{"original_size":{"identifier":"ER06AU09.018","content_type":"image/gif","size":134832,"width":2570,"sha":"a58456e5872279e2070bebead70ddcef","url":"https://img.federalregister.gov/ER06AU09.018/ER06AU09.018_original_size.gif","height":5117}},"ER06AU09.006":{"original_size":{"identifier":"ER06AU09.006","content_type":"image/gif","size":256229,"width":2617,"sha":"c157843241245f4afa09a07e22878d0b","url":"https://img.federalregister.gov/ER06AU09.006/ER06AU09.006_original_size.gif","height":5117}},"ER06AU09.017":{"original_size":{"identifier":"ER06AU09.017","content_type":"image/gif","size":288031,"width":2640,"sha":"43c35b4516df7e3adccd25d5357da130","url":"https://img.federalregister.gov/ER06AU09.017/ER06AU09.017_original_size.gif","height":5117}}},"json_url":"https://www.federalregister.gov/api/v1/documents/E9-18553?publication_date=2009-08-06","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2009-08-06/E9-18553/mods.xml","not_received_for_publication":null,"page_length":50,"page_views":{"count":2593,"last_updated":"2026-10-22 16:15:06 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2009-08-06/pdf/E9-18553.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":null,"publication_date":"2009-08-06","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2009/08/06/E9-18553.txt","regulation_id_number_info":{"0938-AP45":{"issue":"200904","html_url":"https://www.federalregister.gov/regulations/0938-AP45/hospice-wage-index-for-fy-2010-cms-1420-f-","title":"Hospice Wage Index for FY 2010 (CMS-1420-F)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=200904&RIN=0938-AP45&operation=OPERATION_EXPORT_XML","priority_category":"Economically Significant"}},"regulation_id_numbers":["0938-AP45"],"regulations_dot_gov_info":{"supporting_documents":[],"comments_url":"https://www.regulations.gov/docketBrowser?rpp=50&so=DESC&sb=postedDate&po=0&dct=PS&D=CMS_FRDOC_0001","supporting_documents_count":0,"docket_id":"CMS_FRDOC_0001","regulation_id_number":null,"title":"Recently Posted CMS Rules and Notices.","checked_regulationsdotgov_at":"2009-09-01T13:57:06Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":39384,"subtype":null,"title":"Medicare Program; Hospice Wage Index for Fiscal Year 2010","toc_doc":"Hospice Wage Index (Fiscal Year 2010)","toc_subject":"Medicare Program:","topics":["Administrative practice and procedure","Health facilities","Health professions","Hospice care","Kidney diseases","Medical devices","Medicare","Reporting and recordkeeping requirements","Rural areas","X-rays"],"type":"Rule","volume":74}