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Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2012; Changes in Size and Square Footage of Inpatient Rehabilitation Units and Inpatient Psychiatric Units; Correction

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Information about this document as published in the Federal Register.

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Start Preamble

AGENCY:

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

ACTION:

Final rule; correction.

SUMMARY:

This document corrects technical errors that appeared in the final rule published in the Federal Register on August 5, 2011 entitled “Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2012; Changes in Size and Square Footage of Inpatient Rehabilitation Units and Inpatient Psychiatric Units,” (hereinafter FY 2012 IRF PPS final rule (76 FR 47836)).

DATES:

Effective Date. The corrections are effective October 1, 2011.

Start Further Info

FOR FURTHER INFORMATION CONTACT:

Susanne Seagrave, (410) 786-0044.

End Further Info End Preamble Start Supplemental Information

SUPPLEMENTARY INFORMATION:

I. Background

There were technical errors in the August 5, 2011 FY 2012 IRF PPS final rule (76 FR 47836). These technical errors are identified and corrected in the “Summary of Errors” and “Correction of Errors” sections below. The provisions in this correction document are effective as if they were included in the final rule published on August 5, 2011. Accordingly, the corrections are effective October 1, 2011.

II. Summary of Errors

In the August 5, 2011 final rule (76 FR 47836), we applied our established formula for calculating the relative weight values for case-mix groups (CMG). The CMG relative weight values for CMGs 1201, 1202, 1203, 1301, 1302, and 1303 in Table 1 on pages 47842 through 47844 of the final rule did not reflect our policy that the relative weight values for higher-paying tiers must always be greater than or equal to the relative weight values for lower-paying tiers. That is, a tier 1 payment for a given CMG must always be at least as high as a tier 2 payment for that same CMG, the tier 2 payment must always be at least as high as the tier 3 payment, and the tier 3 payment must always be at least as high as the “no-comorbidity” tier payment. We have used this policy in calculating the CMG relative weights since the inception of the IRF PPS. However, we inadvertently did not apply this policy correctly for CMGs 1201, 1202, 1203, 1301, 1302, and 1303 in Table 1 on pages 47842 through 47844 of the FY 2012 IRF PPS final rule.

Further, as discussed in “Step 4” in the CMG relative weights discussion, column 1, on page 47841 of the FY 2012 IRF PPS final rule, we normalized the FY 2012 CMG relative weights to the same average CMG relative weight values from the FY 2011 IRF PPS notice (75 FR 42836). As this process utilized the incorrect values that had been listed for the relative weight values for CMGs 1201, 1202, 1203, 1301, 1302, and 1303, upon correction we also needed to reapply the normalization process to the other CMGs using the corrected relative weight values. This process corrects the relative weight values for all CMGs so that we are appropriately applying the policy of normalizing the FY 2012 CMG relative weights to the same average CMG relative weight values from the FY 2011 IRF PPS notice.

Since the FY 2012 payment rates listed in Table 11 on pages 47865 through 47866 of the final rule are based on the CMG relative weights in Table 1 (the payment rates are equal to the CMG relative weights multiplied by the FY 2012 Standard Payment Conversion Factor), we are also providing corrections to Table 11 in the final rule to reflect the corrections to the CMG relative weights in Table 1. In addition, we are correcting the example of computing the IRF FY 2012 Federal prospective payment in Table 12 on page 47867 of the final rule to reflect the correction to the unadjusted Federal prospective payment rate for CMG 0110 (without comorbidities) from Table 11.

Finally, we utilized the CMG payment rates reflected in Table 11 of the IRF PPS final rule to determine the FY 2012 outlier threshold. As described in the final rule, the outlier threshold is to be set so that the estimated total outlier payments in FY 2012 will equal 3 percent of total estimated payments. Since corrections to the FY 2012 payment rates result in slight differences in the amount of outlier payments we estimate for FY 2012, the use of the corrected data results in an outlier threshold for FY 2012 IRF PPS of $10,713. Therefore, we are correcting the outlier threshold amount for FY 2012 from $10,660 to $10,713 to ensure Start Printed Page 59257that estimated outlier payments for FY 2012 continue to equal 3 percent of total estimated payments.

We note that the corrections to the CMG relative weight values in Table 1 of the FY 2012 IRF PPS final rule do not affect the average length of stay values, which we have republished here for simplicity. The average length of stay values are the same values that were published correctly in Table 1 of the August 5, 2011 final rule (76 FR 47836).

As a result of the corrections to Table 1 and Table 11 of the final rule, as well as the correction to the FY 2012 outlier threshold amount, some of the numbers in Table 14 on page 47887 of the final rule (the IRF Impact Table for FY 2012), also need to be corrected. We are correcting these numbers both in Table 14 and in the preamble text that references Table 14.

III. Waiver of Proposed Rulemaking and Delayed Effective Date

In accordance with the Administrative Procedure Act (APA) (5 U.S.C. 553(b)), we ordinarily publish a notice of proposed rulemaking in the Federal Register to provide a period for public comment before the provisions of a rule take effect. We also ordinarily provide a 30-day delay in the effective date of the provisions of a rule in accordance with section 553(d) of the APA (5 U.S.C. 553(d)). However, we can waive both notice and comment procedures and the 30-day delay in effective date if the Secretary finds, for good cause, that such procedures are impracticable, unnecessary, or contrary to the public interest, and incorporates a statement of the finding and the reasons into the notice.

The corrections that are laid out in this document were necessitated by an inadvertent error to accurately apply our stated policies as we calculated and laid out the CMG relative weight values in Table 1 of the FY 2012 IRF PPS final rule. As a result of those calculation errors, corrections were needed in Tables 1, 11, 12 and 14. Corrections were also needed as a result of these calculation errors in the places indicated above in the preamble discussion.

Upon recognition of these calculation errors, we reviewed the comments that were submitted in response to our FY 2012 IRF PPS proposed rule. We found that the necessary corrections would not have altered the substantive content of those comments.

As the corrections necessitated by the calculation errors outlined above do not change the stated policies in the FY 2012 IRF PPS final rule, as the policies and payment methodology expressed in the FY 2012 IRF PPS final rule (76 FR 47836) have previously been subjected to notice and comment procedures, and as the public's comments would not have been affected if we had published the correctly calculated data elements, we find it unnecessary to undertake further notice and comment procedures with respect to this correction document. Further, the corrections made in this document will not significantly affect anticipated overall reimbursements to IRF providers and, as such, will only result in negligible changes to anticipated revenues and will not necessitate any actions on the part of individual providers. Therefore, we find good cause to waive notice and comment procedures and the 30-day delay in the effective date for this correction document.

IV. Correction of Errors

In the August 5, 2011 FY 2012 IRF PPS final rule (76 FR 47836), make the following corrections:

1. On pages 47842 through 47844, Table 1, “Relative Weights and Average Length of Stay Values for Case-Mix Groups,” is corrected as follows:

Table 1—Relative Weights and Average Length of Stay Values for Case-Mix Groups

CMGCMG Description (M = motor, C = cognitive, A = age)Relative weightAverage length of stay
Tier 1Tier 2Tier 3NoneTier 1Tier 2Tier 3None
0101Stroke M>51.050.76710.71770.64470.6098101098
0102Stroke M>44.45 and M<51.05 and C>18.50.95210.89080.80020.756812131010
0103Stroke M>44.45 and M<51.05 and C<18.51.13691.06370.95550.903714141212
0104Stroke M>38.85 and M<44.451.18121.10520.99280.938915141312
0105Stroke M>34.25 and M<38.851.37251.28411.15351.091016171414
0106Stroke M>30.05 and M<34.251.58051.47881.32841.256420181616
0107Stroke M>26.15 and M<30.051.78951.67431.50401.422520201818
0108Stroke M<26.15 and A>84.52.21652.07381.86291.761931252322
0109Stroke M>22.35 and M<26.15 and A<84.52.04961.91771.72261.629224232020
0110Stroke M<22.35 and A<84.52.64182.47172.22032.100033292625
0201Traumatic brain injury M>53.35 and C>23.50.74660.61280.56770.51548878
0202Traumatic brain injury M>44.25 and M<53.35 and C>23.51.06070.87070.80650.732312121010
0203Traumatic brain injury M>44.25 and C<23.51.20740.99110.91810.833616111312
0204Traumatic brain injury M>40.65 and M<44.251.26491.03830.96180.873316121212
0205Traumatic brain injury M>28.75 and M<40.651.59741.31131.21461.102917181514
0206Traumatic brain injury M>22.05 and M<28.751.98871.63251.51221.373123191918
0207Traumatic brain injury M<22.052.69022.20842.04551.857435272522
0301Non-traumatic brain injury M>41.051.05680.95070.84340.772512121110
0302Non-traumatic brain injury M>35.05 and M<41.051.33831.20391.06810.978212151313
0303Non-traumatic brain injury M>26.15 and M<35.051.59121.43151.26991.163121171514
0304Non-traumatic brain injury M<26.152.20321.98201.75831.610429232019
0401Traumatic spinal cord injury M>48.451.05640.87950.80010.702014141110
0402Traumatic spinal cord injury M>30.35 and M<48.451.37721.14651.04300.915117141312
0403Traumatic spinal cord injury M>16.05 and M<30.352.45882.04701.86221.633929262320
0404Traumatic spinal cord injury M<16.05 and A>63.54.36663.63533.30702.901652393835
0405Traumatic spinal cord injury M<16.05 and A<63.53.85733.21132.92132.563252393629
0501Non-traumatic spinal cord injury M>51.350.65550.62940.56130.4975101077
0502Non-traumatic spinal cord injury M>40.15 and M<51.350.98090.94180.83990.744413131110
0503Non-traumatic spinal cord injury M>31.25 and M<40.151.24531.19561.06630.945016141312
0504Non-traumatic spinal cord injury M>29.25 and M<31.251.50151.44161.28561.139418161614
0505Non-traumatic spinal cord injury M>23.75 and M<29.251.75491.68481.50261.331720211817
0506Non-traumatic spinal cord injury M<23.752.45982.36162.10621.866734282423
0601Neurological M>47.750.94520.79870.72860.6586101199
Start Printed Page 59258
0602Neurological M>37.35 and M<47.751.25111.05720.96440.871712131211
0603Neurological M>25.85 and M<37.351.61571.36541.24551.125817161414
0604Neurological M<25.852.14251.81061.65151.492924211918
0701Fracture of lower extremity M>42.150.79960.78710.75810.67671012109
0702Fracture of lower extremity M>34.15 and M<42.151.04621.02990.99190.885412131212
0703Fracture of lower extremity M>28.15 and M<34.151.25891.23931.19371.065415151414
0704Fracture of lower extremity M<28.151.62701.60171.54261.376918191817
0801Replacement of lower extremity joint M>49.550.57770.57770.53830.49157877
0802Replacement of lower extremity joint M>37.05 and M<49.550.77920.77920.72620.663081199
0803Replacement of lower extremity joint M>28.65 and M<37.05 and A>83.51.07181.07180.99880.911911141312
0804Replacement of lower extremity joint M>28.65 and M<37.05 and A<83.50.95100.95100.88630.809210121110
0805Replacement of lower extremity joint M>22.05 and M<28.651.17341.17341.09360.998411141313
0806Replacement of lower extremity joint M<22.051.43681.43681.33901.222513181615
0901Other orthopedic M>44.750.84600.74550.67460.6112101098
0902Other orthopedic M>34.35 and M<44.751.13160.99710.90230.817512131211
0903Other orthopedic M>24.15 and M<34.351.44931.27701.15561.047016161413
0904Other orthopedic M<24.151.87791.65471.49731.356621201817
1001Amputation, lower extremity M>47.651.03210.90740.81070.724613121010
1002Amputation, lower extremity M>36.25 and M<47.651.35511.19141.06450.951416141312
1003Amputation, lower extremity M<36.252.00181.76001.57251.405521211817
1101Amputation, non-lower extremity M>36.351.03751.03750.98410.923611111211
1102Amputation, non-lower extremity M<36.351.56111.56111.48081.389714181616
1201Osteoarthritis M>37.650.85540.85540.80880.764513131110
1202Osteoarthritis M>30.75 and M<37.651.11521.11521.05440.996616161413
1203Osteoarthritis M<30.751.37371.37371.29891.227713191515
1301Rheumatoid, other arthritis M>36.350.89290.89290.88330.787511101110
1302Rheumatoid, other arthritis M>26.15 and M<36.351.17591.17591.16321.037017171413
1303Rheumatoid, other arthritis M<26.151.51981.51981.50351.340315191816
1401Cardiac M>48.850.94050.75300.66590.6022101098
1402Cardiac M>38.55 and M<48.851.26301.01120.89410.808713121110
1403Cardiac M>31.15 and M<38.551.52541.22131.07990.976718141312
1404Cardiac M<31.151.97571.58181.39871.265124191615
1501Pulmonary M>49.250.96060.89700.77310.7308101189
1502Pulmonary M>39.05 and M<49.251.20911.12900.97320.919813131111
1503Pulmonary M>29.15 and M<39.051.49111.39231.20011.134316161313
1504Pulmonary M<29.151.88361.75891.51601.433022181716
1601Pain syndrome M>37.151.11670.87900.77130.721112121010
1602Pain syndrome M>26.75 and M<37.151.49571.17731.03310.965819131313
1603Pain syndrome M<26.751.93221.52101.33471.247722181615
1701Major multiple trauma without brain or spinal cord injury M>39.251.04240.92770.84190.736010111110
1702Major multiple trauma without brain or spinal cord injury M>31.05 and M<39.251.37551.22421.11100.971213151413
1703Major multiple trauma without brain or spinal cord injury M>25.55 and M<31.051.62231.44391.31041.145515161515
1704Major multiple trauma without brain or spinal cord injury M<25.552.07661.84821.67731.466326222018
1801Major multiple trauma with brain or spinal cord injury M>40.851.19910.98370.94970.868714151211
1802Major multiple trauma with brain or spinal cord injury M>23.05 and M<40.851.64641.35071.30401.192718201515
1803Major multiple trauma with brain or spinal cord injury M<23.052.81882.31242.23252.042034322624
1901Guillian Barre M>35.951.14401.00780.91430.887913141212
1902Guillian Barre M>18.05 and M<35.952.17601.91701.73901.688822222121
1903Guillian Barre M<18.053.63343.20092.90372.819948293432
2001Miscellaneous M>49.150.85330.75400.67600.607391098
2002Miscellaneous M>38.75 and M<49.151.14201.00910.90470.812812121110
2003Miscellaneous M>27.85 and M<38.751.44211.27421.14251.026415151313
2004Miscellaneous M<27.851.93371.70861.53191.376324201816
2101Burns M>02.46862.13681.70171.379334231918
5001Short-stay cases, length of stay is 3 days or fewer0.14743
5101Expired, orthopedic, length of stay is 13 days or fewer0.58517
5102Expired, orthopedic, length of stay is 14 days or more1.470518
5103Expired, not orthopedic, length of stay is 15 days or fewer0.69658
Start Printed Page 59259
5104Expired, not orthopedic, length of stay is 16 days or more1.876423

2. On pages 47865 through 47866, Table 11, “FY 2012 Payment Rates,” is corrected as follows:

Table 11—FY 2012 Payment Rates

CMGPayment rate tier 1Payment rate tier 2Payment rate tier 3Payment rate no comorbidity
0101$10,797.70$10,102.35$9,074.80$8,583.54
010213,401.7612,538.9011,263.6210,652.72
010316,003.0014,972.6413,449.6212,720.48
010416,626.5715,556.8013,974.6513,215.96
010519,319.3118,074.9916,236.6715,356.92
010622,247.1220,815.5918,698.5617,685.09
010725,189.0023,567.4521,170.3020,023.11
010831,199.4529,190.8126,222.1824,800.50
010928,850.1726,993.5524,247.3222,932.62
011037,185.9834,791.6531,252.9429,559.60
020110,509.148,625.777,990.957,254.77
020214,930.4112,255.9711,352.2910,307.85
020316,995.3613,950.7212,923.1811,733.75
020417,804.7314,615.1113,538.3012,292.57
020522,485.0018,457.8617,096.7115,524.42
020627,992.9422,979.0721,285.7319,327.76
020737,867.2631,085.4428,792.4626,144.76
030114,875.5213,382.0511,871.7010,873.71
030218,837.9116,946.1015,034.5813,769.14
030322,397.7320,149.7917,875.1116,371.80
030431,012.2427,898.6324,749.8322,667.99
040114,869.8912,379.8411,262.219,881.35
040219,385.4716,138.1314,681.2712,880.95
040334,610.0728,813.5726,212.3322,998.78
040461,464.2651,170.4846,549.3340,842.92
040554,295.3545,202.2641,120.2236,079.60
05019,226.828,859.437,900.867,002.81
050213,807.1513,256.7811,822.4310,478.17
050317,528.8416,829.2715,009.2413,301.82
050421,135.1120,291.9618,096.1116,038.19
050524,701.9723,715.2421,150.6018,745.01
050634,624.1433,241.8829,646.8726,275.67
060113,304.6411,242.5010,255.779,270.45
060217,610.4814,881.1513,574.8912,270.05
060322,742.5919,219.3717,531.6615,846.76
060430,157.8325,486.0123,246.5121,014.06
070111,255.1711,079.2210,671.029,525.23
070214,726.3114,496.8713,961.9812,462.89
070317,720.2817,444.3916,802.5214,996.57
070422,901.6522,545.5321,713.6419,381.24
08018,131.718,131.717,577.116,918.35
080210,968.0210,968.0210,221.999,332.39
080315,086.6615,086.6614,059.1112,835.90
080413,386.2813,386.2812,475.5611,390.30
080516,516.7816,516.7815,393.5114,053.48
080620,224.4020,224.4018,847.7617,207.91
090111,908.3010,493.669,495.678,603.25
090215,928.4014,035.1812,700.7711,507.13
090320,400.3517,975.0516,266.2314,737.57
090426,433.3223,291.5621,075.9919,095.50
100114,527.8412,772.5611,411.4110,199.47
100219,074.3916,770.1514,983.9013,391.91
100328,177.3424,773.7622,134.5119,783.82
110114,603.8514,603.8513,852.1913,000.59
110221,974.0421,974.0420,843.7419,561.42
120112,040.6112,040.6111,384.6710,761.10
120215,697.5615,697.5614,841.7314,028.14
Start Printed Page 59260
120319,336.2019,336.2018,283.3217,281.11
130112,568.4612,568.4612,433.3311,084.85
130216,551.9716,551.9716,373.2014,596.81
130321,392.7021,392.7021,163.2718,866.06
140113,238.4810,599.239,373.218,476.57
140217,777.9914,233.6512,585.3511,383.26
140321,471.5317,191.0215,200.6713,748.03
140427,809.9522,265.4219,688.1017,807.55
150113,521.4112,626.1710,882.1610,286.74
150217,019.2915,891.8013,698.7612,947.10
150320,988.7219,598.0116,892.6115,966.41
150426,513.5524,758.2821,339.2220,170.91
160115,718.6712,372.8010,856.8210,150.20
160221,053.4716,571.6714,541.9213,594.60
160327,197.6521,409.6018,787.2417,562.63
170114,672.8213,058.3111,850.5810,359.94
170219,361.5417,231.8415,638.4413,670.61
170322,835.4920,324.3418,445.1916,124.06
170429,230.2226,015.2623,609.6720,639.64
180116,878.5313,846.5613,367.9812,227.82
180223,174.7319,012.4518,355.1016,788.45
180339,677.4332,549.3431,424.6728,743.19
190116,102.9414,185.7912,869.6912,498.08
190230,629.3826,983.6924,478.1623,771.55
190351,143.7445,055.8740,872.4839,692.91
200112,011.0510,613.309,515.388,548.35
200216,074.7914,204.0912,734.5611,440.97
200320,299.0017,935.6416,081.8314,447.61
200427,218.7624,050.2521,563.0219,372.80
210134,748.0130,077.6023,953.1319,415.03
50012,074.80
51018,235.87
510220,698.76
51039,803.93
510426,412.21

3. On page 47867:

a. In table 12, “Example of Computing the IRF FY 2012 Federal Prospective Payment,” correct the entire table to read as follows:

Table 12—Example of Computing the IRF PPS FY 2012 Federal Prospective Payment

StepsRural Facility A (Spencer Co., IN)Urban Facility B (Harrison Co., IN)
1Unadjusted Federal Prospective Payment29,559.6029,559.60
2Labor Share0.701990.70199
3Labor Portion of Federal Payment$20,750.54$20,750.54
4CBSA Based Wage Index (shown in the Addendum , Tables 1 and 2)0.83910.8896
5Wage-Adjusted Amount$17,411.78$18,459.68
6Nonlabor Amount$8,809.06$8,809.06
7Wage-Adjusted Federal Payment$26,220.84$27,268.74
8Rural Adjustment1.1841.0000
9Wage- and Rural-Adjusted Federal Payment$31,045.47$27,268.74
10LIP Adjustment1.02281.0666
11FY 2012 Wage-, Rural- and LIP-Adjusted Federal Prospective Payment Rate$31,753.31$29,084.84
12FY 2012 Wage- and Rural-Adjusted Federal Prospective Payment$31,045.47$27,268.74
13Teaching Status Adjustment0.00000.0610
14Teaching Status Adjustment Amount$0.00$1,663.39
15FY2012 Wage-, Rural-, and LIP-Adjusted Federal Prospective Payment Rate$31,753.31$29,084.84
16Total FY 2012 Adjusted Federal Prospective Payment$31,753.31$30,748.23

b. In the 1st column, the 4th paragraph, in line 2, the amount “$31,771.45” is corrected to read “$31,753.31.”

c. In the 1st column, the 2nd paragraph, in line 4, the amount Start Printed Page 59261“$30,765.80” is corrected to read “$30,748.23.”

4. On page 47868, in the 3rd column, in the 1st full paragraph, in line 6, the amount “$10,660” is corrected to read “$10,713.”

5. On page 47887, Table 14, “IRF Impact Table for FY 2012,” is corrected as follows:Start Printed Page 59262

Table 14—IRF Impact Table for FY 2012

Facility classificationNumber of IRFsNumber of casesOutlierFY 2012 adjusted market basket increase factor 1FY 2012 CBSA wage index and labor-shareCMGTotal percent change
(1)(2)(3)(4)(5)(6)(7)(8)
Total1,152397,3880.4%1.8%0.0%0.0%2.2%
Urban unit752200,5870.61.8−0.10.02.3
Rural unit17527,9970.51.80.80.13.2
Urban hospital205162,1710.21.80.00.01.9
Rural hospital206,6330.21.81.6−0.13.5
Urban For-Profit317151,8210.21.80.1−0.12.1
Rural For-Profit6312,4370.41.81.10.13.4
Urban Non-Profit596199,3130.51.8−0.30.02.1
Rural Non-Profit12220,4420.51.80.70.13.1
Urban Government4411,6240.71.80.20.02.8
Rural Government101,7510.91.81.30.14.1
Urban957362,7580.41.8−0.10.02.1
Rural19534,6300.51.80.90.13.2
Urban by region: 2
Urban New England3216,3930.41.8−1.20.01.0
Urban Middle Atlantic14266,3630.31.8−0.70.01.4
Urban South Atlantic13263,7930.41.80.00.02.2
Urban East North Central18857,2690.51.80.00.02.4
Urban East South Central4926,3750.21.80.4−0.12.2
Urban West North Central7318,1180.61.80.00.02.3
Urban West South Central16966,3130.41.80.50.02.7
Urban Mountain7023,8340.41.80.2−0.12.3
Urban Pacific10224,3000.71.8−0.30.02.2
Rural by region: 2
Rural New England61,3541.01.90.70.13.7
Rural Middle Atlantic163,2320.21.81.80.14.0
Rural South Atlantic255,9880.31.80.80.02.9
Rural East North Central335,7760.41.80.10.12.4
Rural East South Central234,0170.21.81.40.03.4
Rural West North Central313,9450.71.8−0.20.12.5
Rural West South Central509,2610.51.81.60.14.0
Rural Mountain76700.61.80.30.22.9
Rural Pacific43871.41.8−0.4−0.12.7
Teaching status:
Non-teaching1,036345,5000.41.80.10.02.3
Resident to ADC less than 10%6936,8780.51.8−0.40.02.0
Resident to ADC 10%-19%3312,4970.61.8−0.30.12.2
Resident to ADC greater than 19%142,5130.71.8−0.7−0.11.8
Disproportionate Share Patient Percentage (DSH):
DSH = 0%3910,5340.41.80.40.02.7
DSH <5%20862,4340.41.8−0.20.02.0
DSH 5%-10%342134,6940.31.80.00.02.2
DSH 10%-20%330123,3980.41.80.00.02.2
DSH >20%23366,3280.51.80.00.02.3
1 This column reflects the impact of the rebased RPL market basket increase factor for FY 2012 of 1.8 percent, which includes a market basket update of 2.9 percent, a 0.1 percentage point reduction in accordance with sections 1886(j)(3)(C)(ii)(II) and 1886(j)(3)(D)(ii) of the Act and a 1.0 percent reduction for the productivity adjustment as required by section 1886(j)(3)(C)(ii)(I) of the Act, as finalized in 76 FR 47860.
2 A map of States that comprise the 9 geographic regions can be found at: http://www.census.gov/​geo/​www/​us_​regdiv.pdf.
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6. On page 47888:

a. In the 1st column, in the 1st full paragraph, in line 18, the amount “$10,660” is corrected to read “$10,713.”

b. In the 1st column, in the 2nd full paragraph, in line 9, the value “1.5” is corrected to read “1.4.”

c. In the 2nd column, the 2nd full paragraph, lines 9 through 14, the sentence: “The largest decrease in payments as a result of these updates is a 0.1 percent decrease to rural freestanding IRFs, urban IRFs in the East South Central and Mountain regions, and rural IRFs in the Pacific region.” is corrected to read, “The largest decrease in payments as a result of these updates is a 0.1 percent decrease to rural IRF hospitals, urban for-profit IRFs, urban IRFs in the East South Central and Mountain regions, rural IRFs in the Pacific region, and teaching IRFs with resident to ADC ratios greater than 19 percent.”

7. On page 47890, in the 1st column, the 2nd full paragraph, lines 1 through 4, the sentence, “Overall the largest payment increase is estimated at 4.1 percent for rural government-owned IRFs and rural IRFs in the West South Central region.” is corrected to read, “Overall, the largest payment increases are estimated at 4.1 percent for rural government-owned IRFs, and 4.0 percent for rural IRFs in the Middle Atlantic and West South Central regions.”

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

Start Signature

Dated: September 19, 2011.

Barbara J. Holland,

Deputy Executive Secretary to the Department.

End Signature End Supplemental Information

[FR Doc. 2011-24671 Filed 9-23-11; 8:45 am]

BILLING CODE 4120-01-P