Medicare and Medicaid Programs and the Children's Health Insurance Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2025 Rates; Quality Programs Requirements; and Other Policy Changes; Correction

<RULE> DEPARTMENT OF HEALTH AND HUMAN SERVICES <SUBAGY>Centers for Medicare & Medicaid Services</SUBAGY> <CFR>42 CFR Parts 405, 412, 413, 431, 482, 485, 495, and 512</CFR> <DEPDOC>[CMS-1808-CN2]</DEPDOC> <RIN>RIN 0938-AV34</RIN> <SUBJECT>Medicare and Medicaid Programs and the Children's Health Insurance Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2025 Rates; Quality Programs Requirements; and Other Policy Changes; Correction</SUBJECT> <HD SOURCE="HED">AGENCY:</HD> Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services HHS. <HD SOURCE="HED">ACTION:</HD> Final rule; correction <SUM> <HD SOURCE="HED">SUMMARY:</HD> This document corrects technical and typographical errors in the final rule that appeared in the August 28, 2024 <E T="04">Federal Register</E> titled “Medicare and Medicaid Programs and the Children's Health Insurance Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2025 Rates; Quality Programs Requirements; and Other Policy Changes” (referred to hereafter as the “FY 2025 IPPS/LTCH PPS final rule”). </SUM> <EFFDATE> <HD SOURCE="HED">DATES:</HD> The corrections in this document are effective October 1, 2024. </EFFDATE> <FURINF> <HD SOURCE="HED">FOR FURTHER INFORMATION CONTACT:</HD> Donald Thompson and Michele Hudson, <E T="03">DAC@cms.hhs.gov,</E> (410) 786-4487, IPPS Payment Rate Issues. Lily Yuan, <E T="03">NewTech@cms.hhs.gov,</E> New Technology Add-On Payments Issues. Benjamin Cohen, <E T="03">benjamin.cohen@cms.hhs.gov,</E> Provider Reimbursement Review Board. Mady Hue, <E T="03">marilu.hue@cms.hhs.gov,</E> and Andrea Hazeley, <E T="03">andrea.hazeley@cms.hhs.gov,</E> MS-DRG Classifications Issues. Jennifer Tate, <E T="03">jennifer.tate@cms.hhs.gov,</E> Hospital-Acquired Condition Reduction Program—Administration Issues. Julia Venanzi, <E T="03">julia.venanzi@cms.hhs.gov,</E> Hospital Inpatient Quality Reporting Program and Hospital Value-Based Purchasing Program—Administration Issues. Jennifer Tate, <E T="03">jennifer.tate@cms.hhs.gov,</E> PPS-Exempt Cancer Hospital Quality Reporting—Administration Issues. Ariel Cress, <E T="03">ariel.cress@cms.hhs.gov</E> or Lorraine Wickiser, <E T="03">lorraine.wickiser@cms.hhs.gov,</E> Long-Term Care Hospital Quality Reporting Program—Administration Issues. Jessica Warren, <E T="03">jessica.warren@cms.hhs.gov</E> and Elizabeth Holland, <E T="03">elizabeth.holland@cms.hhs.gov,</E> Medicare Promoting Interoperability Program. </FURINF> <SUPLINF> <HD SOURCE="HED">SUPPLEMENTARY INFORMATION:</HD> <HD SOURCE="HD1">I. Background</HD> In FR Doc. 2024-07567 of August 28, 2024 (89 FR 68986), there were a number of typographical and technical errors that are identified and corrected in this correcting document. The corrections in this correcting document are applicable to discharges occurring on or after October 1, 2024, as if they had been included in the document that appeared in the August 28, 2024 <E T="04">Federal Register</E> . <HD SOURCE="HD1">II. Summary of Errors</HD> <HD SOURCE="HD2">A. Summary of Error in the Dates Section</HD> On page 68986, we are correcting technical errors in our discussion of the regulatory provisions that are effective November 1, 2024. <HD SOURCE="HD2">B. Summary of Errors in the Preamble</HD> On pages 69060 and 69095, in our discussion of the Change to Specific Medicare Severity Diagnosis-Related Group (MS-DRG) Classifications, we are correcting several inadvertent typographical errors. Under our methodologies as finalized in the FY 2025 IPPS/LTCH PPS final rule, we exclude hospitals that have subsequently converted to rural emergency hospitals (REHs) from certain data and calculations used in the IPPS ratesetting. Specifically, we stated that we exclude REHs, including hospitals that subsequently became REHs after the period from which the data were taken for purposes of developing the MS-DRG relative weights for FY 2025 (89 FR 69109) and from the calculation of the standardized amount (89 FR 69942). In addition, we stated that any hospital that is designated as a REH by 7 days prior to the publication of the preliminary wage index public use file (PUF) is excluded from the calculation of the wage index. We inadvertently treated a current IPPS hospital as a hospital that had converted to REH status, thereby erroneously excluding its data from the MS-DRG relative weight calculation and the wage index (CMS Certification Number (CCN) 260163). Therefore, we restored the applicable data for this hospital for these and other ratesetting calculations, as discussed further in section II.D. of this correcting document. We are correcting an error in the version 42 MS-DRG assignment for some cases in the historical claims data in the FY 2023 MedPAR files used in the ratesetting for the FY 2025 IPPS/LTCH PPS final rule, which resulted in inadvertent errors in the MS-DRG relative weights. (We note this error did not change the associated average length-of-stay (LOS) for the impacted DRGs.) Additionally, the version 42 MS-DRG assignment and relative weights are used when determining total payments for purposes of all of the budget neutrality factors and the final outlier threshold. Therefore, the corrections to the MS-DRG assignment under the version 42 GROUPER for some cases in the historical claims data in the FY 2023 MedPAR files (along with the restoration of the data for CCN 260163 as discussed previously) and the conforming recalculation of the relative weights directly affected the calculation of total payments and required the recalculation of all the budget neutrality factors and the final outlier threshold. On page 69109, we are correcting the number of Medicare discharges from IPPS providers in the FY 2023 MedPAR file used in calculating the relative weights for FY 2025 due to the correction of the number of hospitals with REH status. On page 69113, we are correcting the normalization adjustment factor used in calculating the relative weights for FY 2025 due to the correction of the number of hospitals with REH status, the error in the version 42 MS-DRG assignment for some cases in the historical claims data, and the conforming changes to the relative weights. On page 69268, we are correcting the total number of hospitals that were removed from the FY 2025 IPPS wage index due to conversion to REH status and making a corresponding correction to the number of hospitals' wage data used to calculate the FY 2025 wage index. On page 69277, we are correcting the occupational mix adjusted national average hourly wage due to the inadvertent omission of one hospital's wage data (CCN 260163). (We note, there was no change to the unadjusted national average hourly wage value rounded to 2-digits.) On page 69282 in the discussion of the FY 2025 reclassification application requirements and approvals, due to reclassification errors described in section II.D. of this correcting document, we are correcting the number of hospitals approved for reclassification in FY 2025, the total number of hospitals in reclassification status, and the number of hospitals reclassified back to their geographic urban area. On page 69282, in the discussion of the FY 2025 reclassification application requirements and approvals, we are correcting a typographical error in the date applications for FY 2026 reclassifications are due to the Medicare Geographic Classification Review Board (MGCRB). On page 69291, we inadvertently omitted a hospital from the list of all hospitals subject to our reclassification assignment and reassignment policy for core-based statistical areas (CBSAs) reconfigured due to the migration to Connecticut planning regions and the CBSA assigned or reassigned for FY 2025 under this policy. We are correcting this error by adding a hospital, CCN 220015 to Table Y “HOSPITALS SUBJECT TO RECLASSIFICATION ASSIGNMENT POLICY”. The assignment of the hospital's MGCRB reclassification is discussed further in section II.D. of this correcting document. On page 69308, because we restored the wage data for a IPPS hospital that we inadvertently treated as a REH and recalculated the wage index (as discussed earlier in this section) and made corrections to the MGCRB reclassification status of three hospitals (as discussed in section II.D. of this correcting document), we recalculated budget neutrality factors, including the rural floor budget neutrality factor, which is the only budget neutrality factor applied to the FY 2025 wage indexes (as discussed in section II.D. of this correcting document), made conforming changes to the out-migration adjustment discussed in section II.E. of this correcting document (as discussed with regard to Table 4A in section II.E. of this correcting document) and made a conforming change to the 25th percentile wage index value across all hospitals. On pages 69313 and 69315, we are correcting typographical errors in the number of hospitals that may participate in the Rural Community Hospital Demonstration Program at the start of FY 2025. On page 69369, we inadvertently omitted a reference to population health professional shortage areas (HPSAs) when summarizing the prioritization methodology for the distribution any remaining slots after awarding up to 1.00 FTE to each qualifying hospital under section 4122 of the Consolidated Appropriations Act, 2023. On page 69400, in our discussion of the Hospital Readmissions Reduction Program, we are correcting a typographical error. On pages 69455, 69458, 69463, 69476, 69481, 69489, 69529, 69533, 69534, 69538, 69540, 69544, 69545, 69549, 69572, 69 ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Preview showing 10k of 63k characters. Full document text is stored and available for version comparison. ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━