Federal Register - October 4, 2021
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Source: Federal Register
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Federal Register / Vol. 86, No. 189 / Monday, October 4, 2021 / Rules and Regulations
payments will be a net increase of approximately $80 million. This reflects an $75 million increase from the update to the payment rates +$100 million from the 2nd quarter 2021 IGI forecast of the 2016-based IPF market basket of 2.7 percent, and $25 million for the productivity adjustment of 0.7
percentage point, as well as a $5
million increase as a result of the update to the outlier threshold amount. Outlier payments are estimated to change from 1.9 percent in FY 2021 to 2.0 percent of total estimated IPF payments in FY
2022. This paragraph should be revised to reflect that outlier payments are estimated to change from 2.1 percent in FY 2021 to 2.0 percent in FY 2022, and that the update to the outlier threshold will result in a $5 million decrease and a net increase of approximately $70
million in FY 2022 payments.
On page 42672 in the third column, in the fourth full paragraph under C.
Detailed Economic Analysis, $80
million should be replaced with $70
million and $5 million increase should be replaced with $5 million decrease.
On pages 42674 and 42675, Table 18
reflects the impact to providers of updating the outlier fixed dollar loss threshold amount based on the inaccurate calculation of estimated FY
2021 outlier payments; therefore, Table 18 should be updated to reflect the correct calculations.
On page 42675 in the first column, in the second full paragraph under 3.
Impact Results, we incorrectly stated that the number of IPFs included in the analysis for FY 2019 claims is 1,519.
The correct number is 1,520 IPFs.
On page 42675, in the first column, in the third full paragraph, we incorrectly stated that Based on the FY 2019
claims, we would estimate that IPF
outlier payments as a percentage of total IPF payments are 1.9 percent in FY
2021. The correct percentage should be 2.1 percent.
On page 42675, in the second column, in the first full paragraph, we incorrectly stated that Based on the FY
2019 claims, the estimated change in total IPF payments for FY 2022 would include an approximate 0.1 percent increase in payments because we would expect the outlier portion of total payments to increase from approximately 1.9 percent to 2.0
percent. This should be corrected to reflect that the estimated change in total IPF payments for FY 2022 would include an approximate 0.1 percent decrease in payments because we would expect the outlier portion of total payments to decrease from
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approximately 2.1 percent to 2.0
percent.
On page 42675, in the second column, in the second full paragraph and continuing into the first paragraph of the third column, we incorrectly stated the overall impact and the impact to certain provider types due to updating the outlier fixed dollar loss threshold amount. We stated that the overall impact across all hospital groups is an increase of 0.1 percent, however the overall impact is actually a decrease of 0.1 percent. We also stated that the largest increase in payments due to this change is estimated to be 0.4 percent for teaching IPFs with more than 30 percent interns and residents to beds. This should be corrected to reflect that the largest decreases in payments are estimated to be 0.4 percent for urban government IPF units and 0.4 percent for teaching IPFs with more than 30
percent interns and residents to beds.
On page 42676, in the first column, in the first full paragraph, we incorrectly stated that The average estimated increase for all IPFs is approximately 2.1 percent based on the FY 2019
claims, and that this overall increase includes the overall estimated 0.1
percent increase in estimated IPF outlier payments as a percent of total payments from updating the outlier fixed dollar loss threshold amount. These statements should be corrected to reflect that the average estimated increase for all IPFs is approximately 1.9 percent, and that this includes the overall estimated 0.1 percent decrease in estimated IPF outlier payments as a percent of total payments from updating the outlier fixed dollar loss threshold amount.
On page 42676, in the second column, in the first full paragraph, we incorrectly stated that IPF payments are therefore estimated to increase by 2.1 percent in urban areas and 2.2
percent in rural areas based on this finalized policy. Overall, IPFs are estimated to experience a net increase in payments as a result of the updates in this final rule. The largest payment increase is estimated at 2.7 percent for IPFs in the South Atlantic region. It is still correct that IPFs are estimated to experience a net increase in payments as a result of the updated in this final rule, however these statements should be corrected to reflect that IPF payments are estimated to increase by 1.8 percent in urban areas and 2.1 percent in rural areas, and that the largest increases are estimated at 2.5 percent for IPFs in the South Atlantic region and 2.5 percent for rural, government-owned IPF
hospitals.
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On page 42677, in the third column, in the first full paragraph, we incorrectly stated that the number of IPFs with data available in the PSF and with claims in our FY 2019 MedPAR
claims dataset was 1,519. The correct number should be 1,520.
On page 42677, Table 19 incorrectly states that the estimate of annualized monetized transfers from the federal government to IPF Medicare providers is $80 million. This table should be corrected to reflect that the estimate of annualized monetized transfers from the federal government to IPF Medicare providers is $70 million.
On page 42677, under F. Regulatory Flexibility Act, in the third column, in line 10, we incorrectly stated that the number of IPFs in our database is 1,519.
The correct number of IPFs in our database is 1,520.
B. Summary of Errors and Corrections to the IPF PPS Addenda Posted on the CMS Website In Addendum A of the FY 2022 IPF
PPS final rule, we have corrected the outlier fixed dollar loss threshold amount from $14,470 to $16,040 on the CMS website at: https www.cms.gov/
Medicare/Medicare-Fee-for-ServicePayment/InpatientPsychFacilPPS/tools.
III. Waiver of Proposed Rulemaking 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 in accordance with section 553b of the Administrative Procedure Act APA 5 U.S.C. 553b. However, we can waive this notice and comment procedure if the Secretary finds, for good cause, that the notice and comment process is impracticable, unnecessary, or contrary to the public interest, and incorporates a statement of the finding and the reasons therefore in the rule.
Section 553d of the APA ordinarily requires a 30-day delay in effective date of final rules after the date of their publication in the Federal Register.
This 30-day delay in effective date can be waived, however, if an agency finds for good cause that the delay is impracticable, unnecessary, or contrary to the public interest, and the agency incorporates a statement of the findings and its reasons in the rule issued.
We believe that this correcting document does not constitute a rule that would be subject to the notice and comment or delayed effective date requirements. This document corrects technical and typographic errors in the preamble of the FY 2022 IPF PPS final rule, but does not make substantive
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