07-2806. Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates; Correction

AGENCY:

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

ACTION:

Correction of proposed rule.

SUMMARY:

This document corrects technical errors that appeared in the proposed rule entitled “Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates” that appeared in the May 3, 2007 Federal Register.

FOR FURTHER INFORMATION CONTACT:

Marc Hartstein, [phone].

SUPPLEMENTARY INFORMATION:

I. Background

In FR Doc. 07-1920 of May 3, 2007 (72 FR 24680), there were a number of technical errors that are identified and corrected in the Correction of Errors section of this notice. We issued the fiscal year (FY) 2008 hospital inpatient prospective payment systems (IPPS) proposed rule on April 13, 2007. The FY 2008 IPPS proposed rule appeared in the May 3, 2007 Federal Register.

II. Summary of Errors

We recently discovered that an error was made in the calculation of the DRG relative weights presented in the FY 2008 IPPS proposed rule. We have revised the relative weights to correct the error and have recalculated the standardized amounts. These changes increase the standardized amounts slightly and reduce the proposed FY 2008 outlier threshold by $85. Further, these revisions affect the DRG-specific costs thresholds for new technology add-on payments. Therefore, in this notice we are correcting the following:

• Preamble language regarding the methodology used to calculate charge-based and cost-based relative weights.
• Outlier threshold.
• Recalibration, wage and recalibration, geographic reclassification, and rural floor budget neutrality factors.
• Tables 1A through 1D, 2, 4A, 4C, 4J, 5, 10.
• Impact analysis tables (Tables I and II).

In addition, we have posted these corrected tables on our Web site at http://www.cms.hhs.gov/​AcuteInpatientPPS/​WIFN/​list.asp.

III. Correction of Errors

In FR Doc. 07-1920 of May 3, 2007 (72 FR 24680), make the following corrections:

A. Corrections to the Preamble

1. On page 24711, second column, last paragraph, sixth line from the bottom, the figure “$23,015” is corrected to read “$22,930.”

2. On page 24746, second column,

a. Third full paragraph, line 9, the phrase, “in the FY 2005 MedPAR” is corrected to read “in the FY 2006 MedPAR.”

b. Fifth full paragraph, last line, after the phrase “cost of living adjustment.”, the following sentence is added to read as follows:

“Beginning with FY 2008, because hospital charges include charges for both operating and capital costs, we are proposing to standardize total charges to remove the effects of differences in geographic adjustment factors, large urban add-on payments, cost-of-living adjustment, disproportionate share payments, and IME adjustments under the capital IPPS as well.”

3. On page 24747, first column, third full paragraph, last line, after the phrase “cost of living adjustment.” and before the phrase “Charges were then”, the following sentence is added to read as follows:

“Beginning with FY 2008, because hospital charges include charges for both operating and capital costs, we are proposing to standardize total charges to remove the effects of differences in geographic adjustment factors, large urban add-on payments, cost-of-living adjustment, disproportionate share payments, and IME adjustments under the capital IPPS as well.”

B. Corrections to the Addendum

1. On page 24836,

a. First column, second full paragraph,

(1) Line 14, the figure “0.999317” is corrected to read “0.999367.”

(2) Lines 19 and 29, the figure “0.998557” is corrected to read “0.998573.”

b. Second column, first partial paragraph, line 17, the figure “0.991938” is corrected to read “0.991925.”

2. On page 24837, second column, second full paragraph, line 6, the figure “$23,015” is corrected to read “$22,930”.

3. On page 24839, top half of the page, in the table Comparison of FY 2007 Standardized Amounts to Proposed FY 2008 Single Standardized Amount with Full Update and Reduced Update, the figures in the listed entries are corrected to read as follows:

	Full update (3.3 percent)	Reduced update (1.3 percent)
FY 2008 DRG Recalibrations and Wage Index Budget Neutrality Factor	0.999367	0.999367
FY 2008 Reclassification Budget Neutrality Factor	0.991925	0.991925

4. On page 24846, third column, first full paragraph,

a. Line 38, the figure “$417.26” is corrected to read “$417.12.”

b. Line 40, the figure “$413.87” is corrected to read “$413.73.”

5. On page 24847,

a. Middle of the page, in the table Comparison of Factors and Adjustments: FY 2007 Capital Federal Rate and Proposed FY 2008 Capital Federal Rate for Urban Hospitals, third column, last row, the figure, “$413.87” is corrected to read “$413.73.”

b. Lower third of the page, in the table Comparison of Factors and Adjustments: FY 2007 Capital Federal Rate and Proposed FY 2008 Capital Federal Rate for Rural Hospitals, third column, last row, the figure “$417.26” is corrected to read “$417.12.”

6. On page 24848,

a. First column, fourth full paragraph,

(1) Line 10, the phrase “is $197.21” is corrected to read “is $197.11.”.

(2) Line 12, the figure “$195.60” is corrected to read “$195.51.”

b. Second column, third paragraph, last line, the figure “$23,015” is corrected to read “$22,930”.

7. On page 24850, in Table 1A.—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (69.7 Percent Labor Share/30.3 Percent Nonlabor Share If Wage Index Greater Than 1), the table is corrected to read as follows:

Table 1A.—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (69.7 Percent Labor Share/30.3 Percent Nonlabor Share If Wage Index Greater Than 1)

Full update (3.3 percent)		Reduced update (1.3 Percent)
Labor-related	Nonlabor-related	Labor-related	Nonlabor-related
$3,430.41	$1,491.27	$3,363.99	$1,462.40

8. On page 24850, in Table 1B.—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (62 Percent Labor Share/38 Percent Nonlabor Share If Wage Index Less Than Or Equal To 1), the table is corrected to read as follows:

Table 1B.—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (62 Percent Labor Share/38 Percent Nonlabor Share If Wage Index Less Than or Equal to 1)

Full update (3.3 percent)		Reduced update (1.3 Percent)
Labor-related	Nonlabor-related	Labor-related	Nonlabor-related
$3,051.44	$1,870.24	$2,992.36	$1,834.03

9. On page 24850, in Table 1C.—Adjusted Operating Standardized Amounts For Puerto Rico Labor, Labor/Nonlabor, the table is corrected to read as follows:

Table 1C.—Adjusted Operating Standardized Amounts for Puerto Rico, Labor/Nonlabor

	Rates if wage index greater than 1		Rates if wage index less than or equal to 1
	Labor	Nonlabor	Labor	Nonlabor
National	$3,430.41	$1,491.27	$3,363.99	$1,462.40
Puerto Rico	1,442.16	883.90	1,365.40	960.66

10. On page 24850, in Table 1D.—Capital Standard Federal Payment Rate, the table is corrected to read as follows:

Table 1D.—Capital Standard Federal Payment Rate

	Urban rate	Rural rate
National	$413.73	$417.12
Puerto Rico	195.51	197.11

11. On pages 24851 through 24917, in Table 2.—Hospital Case-Mix Indexes For Discharges Occurring in Federal Fiscal Year 2006; Hospital Wage Indexes For Federal Fiscal Year 2008; Hospital Average Hourly Wages For Federal Fiscal Years 2006 (2002 Wage Data), 2007 (2003 Wage Data), And 2008 (2004 Wage Data); And 3-Year Average Of Hospital Average Hourly Wages, the wage index for the listed provider numbers are corrected to read as follows:

Provider No.	FY 2008 wage index
010012	0.9390
010047	0.7776
010052	0.7701
010109	0.8049
010110	0.7900
010164	0.8042
040014	0.8720
040017	0.8718
040041	0.8720
040071	0.8720
040076	0.8720
040078	0.8720
040100	0.8720
040119	0.8720
050007	1.4907
050008	1.4792
050009	1.4200
050013	1.4200
050016	1.2015
050047	1.4792
050055	1.4792
050070	1.4907
050113	1.4907
050152	1.4792
050228	1.4792
050232	1.2015
050280	1.2826
050289	1.4907
050407	1.4792
050454	1.4792
050457	1.4792
050506	1.2015
050633	1.2015
050667	1.4200
050668	1.4792
050697	1.2826
050707	1.4907
050733	1.2826
050754	1.4907
060010	0.9730
060030	0.9730
080001	1.0777
080003	1.0777
100102	0.8874
100290	0.9331
110107	0.9752
110164	0.9752
110201	0.9752
130066	0.9680
130068	0.9680
150015	0.8904
160030	1.0022
180013	0.9407
180064	0.8131
180066	0.9407
180079	0.8075
180080	0.8042
180124	0.9407
190044	0.7849
190190	0.7752
190246	0.7752
200032	0.8878
210028	0.9429
230036	0.9398
230041	0.9398
230047	1.0091
230080	0.9398
230105	0.9398
230195	1.0091
230204	1.0091
230222	0.9398
230227	1.0091
230257	1.0091
230264	1.0091
230297	1.0091
230299	1.0091
230300	1.0091
240006	1.0760
240010	1.0760
240018	1.0084
240061	1.0760
240069	1.0760
240071	1.0760
270081	0.8574
280065	0.9746
310010	1.0812
310011	1.0864
310014	1.0777
310044	1.0812
310081	1.0777
310092	1.0812
310110	1.0812
320001	0.9739
320005	0.9739
320006	0.9739
320009	0.9739
320011	0.9407
320017	0.9739
320019	0.9739
320021	0.9739
320037	0.9739
320074	0.9739
320079	0.9739
320083	0.9739
330135	1.1528
330205	1.1528
330264	1.1528
340133	0.8916
360044	0.8825
370113	0.8718
380029	1.0479
380051	1.0479
380056	1.0479
390044	1.0777
390096	1.0777
390133	1.0777
410013	1.1793
430012	0.9394
430013	0.9394
430048	0.8398
440011	0.8042
440015	0.8042
440019	0.8042
440030	0.7972
440034	0.8042
440035	0.9407
440056	0.8042
440073	0.9407
440084	0.7949
440110	0.8042
440120	0.8042
440125	0.8042
440144	0.9407
440148	0.9407
440151	0.9407
440153	0.7923
440173	0.8042
440175	0.9407
440192	0.9407
440225	0.8042
440226	0.8042
450370	0.8444
450565	0.8690
450755	0.8498

12. On pages 24924, 29426, and 24941, in Table 4A.—Wage Index and Capital Geographic Adjustment Factor (GAF) for Urban Areas by CBSA—FY 2008, the wage index and GAF for the listed CBSAs are corrected to read as follows:

CBSA code	Urban area	Wage index	GAF
10740	Albuquerque, NM	0.9739	0.9821
	Bernalillo County, NM
	Sandoval County, NM
	Torrance County, NM
	Valencia County, NM
13020	Bay City MI	0.9398	0.9584
	Bay County, MI
40340	Rochester, MN	1.0760	1.0514
	Dodge County, MN
	Olmsted County, MN
	Wabasha County, MN

13. On pages 24948 through 24951, in Table 4C.—Wage Index And Capital Geographic Adjustment Factor (GAF) For Hospitals That Are Reclassified By CBSA FY 2008, the wage indices and GAFs for the listed areas are corrected to read as follows:

CBSA code	Area	Wage index	GAF
10740	Albuquerque, NM	0.9739	0.9821
13020	Bay City, MI	0.9398	0.9584
22220	Fayetteville-Springdale-Rogers, AR-MO	0.8718	0.9103
35980	Norwich-New London, CT	1.1793	1.1196
40340	Rochester, MN	1.0760	1.0514
40660	Rome, GA	0.9390	0.9578
43620	Sioux Falls, SD	0.9394	0.9581

14. On pages 24952 through 24960, in Table 4J.—Out-Migration Adjustment—FY 2008, the entries for the listed providers are corrected to read as follows:

Provider No.	Reclassified for FY 2008	Out-migration adjustment	Qualifying county name	County code
010009	*	0.0092	MORGAN	01510
010025	*	0.0235	CHAMBERS	01080
010038		0.0039	CALHOUN	01070
010047		0.0178	BUTLER	01060
010052		0.0103	TALLAPOOSA	01610
010054	*	0.0092	MORGAN	01510
010065	*	0.0103	TALLAPOOSA	01610
010078		0.0039	CALHOUN	01070
010085	*	0.0092	MORGAN	01510
010109		0.0451	PICKENS	01530
010110		0.0302	BULLOCK	01050
010146		0.0039	CALHOUN	01070
010150	*	0.0178	BUTLER	01060
050007		0.0141	SAN MATEO	05510
050008		0.0026	SAN FRANCISCO	05480
050016		0.0103	SAN LUIS OBISPO	05500
050047		0.0026	SAN FRANCISCO	05480
050055		0.0026	SAN FRANCISCO	05480
050070		0.0141	SAN MATEO	05510
050076	*	0.0026	SAN FRANCISCO	05480
050113		0.0141	SAN MATEO	05510
050152		0.0026	SAN FRANCISCO	05480
050194	*	0.0052	SANTA CRUZ	05540
050197	*	0.0141	SAN MATEO	05510
050228		0.0026	SAN FRANCISCO	05480
050232		0.0103	SAN LUIS OBISPO	05500
050242	*	0.0052	SANTA CRUZ	05540
050289		0.0141	SAN MATEO	05510
050407		0.0026	SAN FRANCISCO	05480
050454		0.0026	SAN FRANCISCO	05480
050457		0.0026	SAN FRANCISCO	05480
050506		0.0103	SAN LUIS OBISPO	05500
050541	*	0.0141	SAN MATEO	05510
050633		0.0103	SAN LUIS OBISPO	05500
050668		0.0026	SAN FRANCISCO	05480
050707		0.0141	SAN MATEO	05510
050714	*	0.0052	SANTA CRUZ	05540
050754		0.0141	SAN MATEO	05510
060010		0.0153	LARIMER	06340
060030		0.0153	LARIMER	06340
080001	*	0.0063	NEW CASTLE	08010
080003	*	0.0063	NEW CASTLE	08010
100102		0.0125	COLUMBIA	10110
100156	*	0.0125	COLUMBIA	10110
100290		0.0582	SUMTER	10590
110146	*	0.0805	CAMDEN	11170
130049	*	0.032	KOOTENAI	13270
130066		0.032	KOOTENAI	13270
130067	*	0.0696	BINGHAM	13050
130068		0.032	KOOTENAI	13270
140167	*	0.1055	IROQUOIS	14460
150006	*	0.0113	LA PORTE	15450
150015		0.0113	LA PORTE	15450
150146	*	0.0319	NOBLE	15560
160030		0.004	STORY	16840
170137	*	0.0336	DOUGLAS	17220
180064		0.0319	MONTGOMERY	18860
180066	*	0.0449	LOGAN	18700
180079		0.0263	HARRISON	18480
190044		0.0258	ACADIA	19000
190099	*	0.0188	AVOYELLES	19040
190184	*	0.0161	CALDWELL	19100
190190		0.0161	CALDWELL	19100
190246		0.0161	CALDWELL	19100
200032		0.0466	OXFORD	20080
210028		0.0512	ST. MARY'S	21180
230069	*	0.0209	LIVINGSTON	23460
230279	*	0.0209	LIVINGSTON	23460
240018		0.0872	GOODHUE	24240
270081		0.0237	MUSSELSHELL	27320
300011	*	0.0069	HILLSBOROUGH	30050
300012	*	0.0069	HILLSBOROUGH	30050
300020	*	0.0069	HILLSBOROUGH	30050
300034	*	0.0069	HILLSBOROUGH	30050
310010		0.0092	MERCER	31260
310011		0.0115	CAPE MAY	31180
310021	*	0.0092	MERCER	31260
310044		0.0092	MERCER	31260
310092		0.0092	MERCER	31260
310110		0.0092	MERCER	31260
320003	*	0.0629	SAN MIGUEL	32230
320011		0.0442	RIO ARRIBA	32190
330027	*	0.0149	NASSAU	33400
330106	*	0.0149	NASSAU	33400
330167	*	0.0149	NASSAU	33400
330181	*	0.0149	NASSAU	33400
330182	*	0.0149	NASSAU	33400
330198	*	0.0149	NASSAU	33400
330225	*	0.0149	NASSAU	33400
330259	*	0.0149	NASSAU	33400
330331	*	0.0149	NASSAU	33400
330332	*	0.0149	NASSAU	33400
330372	*	0.0149	NASSAU	33400
340133		0.0308	MARTIN	34580
360010	*	0.0076	TUSCARAWAS	36800
360013	*	0.0136	SHELBY	36760
360025	*	0.0072	ERIE	36220
360044		0.0124	DARKE	36190
360096	*	0.0072	COLUMBIANA	36140
360175	*	0.0176	CLINTON	36130
360185	*	0.0072	COLUMBIANA	36140
380022	*	0.0068	LINN	38210
380029		0.0075	MARION	38230
380051		0.0075	MARION	38230
380056		0.0075	MARION	38230
390030	*	0.0284	SCHUYLKILL	39650
390031	*	0.0284	SCHUYLKILL	39650
390065	*	0.049	ADAMS	39000
390138	*	0.0213	FRANKLIN	39350
390151	*	0.0213	FRANKLIN	39350
390162	*	0.02	NORTHAMPTON	39590
390181	*	0.0284	SCHUYLKILL	39650
390183	*	0.0284	SCHUYLKILL	39650
390313	*	0.0284	SCHUYLKILL	39650
420009	*	0.0113	OCONEE	42360
420039	*	0.0153	UNION	42430
420062	*	0.0109	CHESTERFIELD	42120
440030		0.0056	HAMBLEN	44310
440067	*	0.0056	HAMBLEN	44310
440084		0.0033	MONROE	44610
440153		0.0007	COCKE	44140
450324	*	0.0132	GRAYSON	45564
450370		0.024	COLORADO	45312
450393	*	0.0132	GRAYSON	45564
450395	*	0.0451	POLK	45850
450438	*	0.024	COLORADO	45312
450469	*	0.0132	GRAYSON	45564
450565		0.0486	PALO PINTO	45841
450755		0.0294	HOCKLEY	45652
510077	*	0.0021	MINGO	51290

15. On pages 24960 through 24977, in Table 5.—List of Proposed Medicare Severity-Diagnosis Related Groups (MS-DRGs), Relative Weighting Factors, and Geometric and Arithmetic Mean Length of Stay, the table is corrected to read as follows:

16. On pages 25095 through 25099, in Table 10.—Geometric Mean Plus The Lesser of .75 Of The National Adjusted Operating Standardized Payment Amount (Increased To Reflect The Difference Between Costs And Charges) Or .75 Of One Standard Deviation Of Mean Charges By Proposed Medicare Severity Diagnosis Related Group (MS-DRG) April 2007,^[1] the table is corrected to read as follows:

Proposed MS-DRG	Number of cases	Threshold
1	629	$337,776
2	328	177,459
3	23,999	266,199
4	21,742	162,448
5	842	159,506
6	495	90,877
7	413	130,276
8	560	92,482
9	1,358	96,148
10	177	72,498
11	1,289	71,569
12	1,923	51,377
13	1,484	36,890
20	901	138,451
21	558	107,625
22	251	74,547
23	3,112	81,762
24	2,576	60,740
25	8,417	79,522
26	11,626	52,970
27	14,454	41,141
28	1,609	73,994
29	2,862	45,280
30	3,751	30,578
31	1,057	59,862
32	2,987	35,341
33	4,263	30,562
34	813	58,045
35	2,506	42,020
36	7,710	36,365
37	4,777	51,688
38	14,602	33,107
39	55,357	25,687
40	4,549	58,682
41	7,720	39,547
42	5,430	34,186
52	1,156	29,433
53	593	22,836
54	4,664	30,610
55	16,896	24,934
56	7,716	29,072
57	48,432	19,657
58	789	28,525
59	2,639	22,939
60	4,201	17,679
61	1,340	53,318
62	2,288	41,979
63	1,185	36,186
64	55,552	34,358
65	112,189	27,004
66	94,547	21,586
67	1,383	30,616
68	12,393	23,506
69	103,747	18,936
70	7,092	34,031
71	10,001	26,444
72	6,056	20,628
73	8,655	26,844
74	32,523	21,427
75	1,197	33,931
76	874	24,318
77	1,101	32,854
78	1,307	24,933
79	957	20,523
80	2,077	24,135
81	8,190	17,502
82	1,646	33,910
83	1,940	28,383
84	2,591	22,654
85	5,328	35,679
86	10,382	26,404
87	12,152	20,144
88	717	30,107
89	2,641	23,706
90	3,319	17,874
91	6,676	29,690
92	14,890	22,313
93	15,484	17,172
94	1,521	56,938
95	1,088	42,964
96	755	36,338
97	1,252	51,314
98	1,048	35,977
99	642	30,167
100	15,837	28,714
101	56,905	19,341
102	1,352	24,321
103	15,023	17,133
113	568	31,544
114	601	21,640
115	1,098	25,563
116	665	23,828
117	1,400	16,827
121	587	22,514
122	674	13,518
123	2,843	19,108
124	679	24,153
125	4,705	16,568
129	1,374	37,663
130	1,072	28,539
131	655	35,824
132	728	27,050
133	1,352	31,142
134	2,661	20,306
135	781	35,301
136	1,113	24,451
137	1,108	28,410
138	1,370	20,587
139	2,145	22,300
146	687	35,060
147	1,422	25,142
148	935	18,944
149	39,248	15,883
150	939	25,105
151	6,801	13,607
152	2,352	22,958
153	16,028	15,145
154	1,843	27,851
155	4,207	22,020
156	5,140	16,103
157	1,145	28,232
158	3,039	21,662
159	2,418	15,345
163	13,431	79,829
164	18,047	47,971
165	14,553	37,942
166	20,290	58,779
167	20,772	40,117
168	5,758	30,294
175	11,954	33,475
176	40,173	26,670
177	57,179	36,617
178	71,192	30,381
179	27,454	24,673
180	22,474	32,948
181	32,156	26,822
182	6,163	22,468
183	1,654	29,694
184	4,141	22,561
185	2,593	15,740
186	8,533	31,857
187	9,968	25,761
188	5,148	20,974
189	104,531	28,757
190	57,041	27,770
191	121,659	24,280
192	196,903	18,419
193	88,053	29,668
194	266,599	24,679
195	147,744	18,274
196	5,143	30,999
197	6,894	25,721
198	4,943	21,129
199	3,257	33,231
200	8,185	23,984
201	3,523	17,676
202	31,587	20,635
203	41,587	15,003
204	26,039	17,394
205	5,775	26,368
206	22,415	18,854
207	46,165	83,212
208	79,432	41,398
215	150	151,502
216	8,411	165,422
217	7,609	118,088
218	3,256	98,470
219	10,062	132,460
220	13,481	94,478
221	8,383	81,144
222	2,865	149,784
223	5,770	116,219
224	1,919	138,213
225	5,871	109,030
226	7,048	112,464
227	50,536	88,444
228	3,084	126,976
229	4,128	89,139
230	1,989	73,311
231	1,478	138,287
232	1,795	107,403
233	16,911	119,988
234	39,167	86,734
235	9,628	97,022
236	32,871	68,172
237	21,789	85,211
238	44,929	53,794
239	13,814	64,168
240	13,349	43,051
241	3,350	31,297
242	17,179	64,273
243	37,856	50,218
244	68,201	42,102
245	6,241	54,054
246	32,661	64,613
247	279,972	46,787
248	5,013	58,218
249	29,657	41,876
250	5,739	53,408
251	39,905	38,200
252	44,602	48,168
253	46,864	43,475
254	59,029	34,550
255	2,609	39,961
256	3,833	30,250
257	774	23,818
258	598	49,682
259	7,328	35,034
260	867	47,446
261	2,804	28,303
262	3,378	23,301
263	788	29,053
264	30,137	39,708
280	60,735	36,717
281	57,734	28,584
282	60,951	23,031
283	15,852	30,928
284	4,911	23,409
285	3,254	17,351
286	23,282	40,266
287	172,488	28,923
288	3,245	50,617
289	1,423	36,464
290	484	28,249
291	183,774	29,157
292	217,052	24,421
293	226,688	17,810
294	1,704	21,989
295	1,658	13,805
296	1,730	26,654
297	943	20,306
298	554	12,889
299	17,443	28,063
300	46,820	21,997
301	39,910	15,712
302	7,873	23,741
303	81,458	15,192
304	2,084	24,110
305	35,646	15,139
306	1,379	27,644
307	6,447	18,857
308	33,528	27,255
309	79,751	20,827
310	160,738	14,816
311	24,867	13,364
312	169,247	18,273
313	220,769	14,894
314	60,053	30,750
315	30,730	23,629
316	20,101	16,823
326	11,567	88,786
327	10,901	49,818
328	9,333	32,074
329	48,135	80,371
330	66,303	47,127
331	31,391	35,021
332	1,890	74,102
333	6,196	46,130
334	4,023	34,266
335	7,161	68,407
336	12,516	43,200
337	8,835	32,563
338	1,499	58,047
339	3,192	39,795
340	3,607	30,753
341	874	42,806
342	2,536	31,921
343	6,875	24,258
344	898	51,426
345	2,915	33,636
346	2,909	27,779
347	1,568	36,443
348	3,985	27,800
349	5,787	19,265
350	1,669	41,035
351	3,997	28,329
352	8,419	19,894
353	3,182	44,303
354	9,118	30,612
355	17,451	23,281
356	8,366	58,953
357	8,046	40,130
358	2,714	31,167
368	3,052	31,502
369	4,005	25,728
370	3,914	20,084
371	16,843	32,446
372	22,903	26,907
373	14,897	20,598
374	9,414	34,760
375	19,730	26,563
376	4,816	22,403
377	50,503	30,943
378	84,806	24,936
379	128,748	19,140
380	2,917	32,583
381	4,894	26,915
382	5,445	20,581
383	1,303	28,065
384	8,664	21,556
385	2,107	33,476
386	7,221	25,067
387	5,230	20,543
388	18,267	29,699
389	46,328	23,347
390	48,052	16,336
391	47,511	24,761
392	306,515	17,829
393	23,917	28,925
394	45,952	23,434
395	26,460	17,594
405	3,903	83,940
406	5,241	49,125
407	2,310	36,497
408	1,644	67,203
409	1,713	46,400
410	722	35,648
411	978	65,359
412	1,063	47,834
413	881	37,325
414	5,596	59,660
415	6,847	40,610
416	6,222	30,251
417	16,671	46,291
418	27,563	36,466
419	38,264	28,533
420	714	61,258
421	1,091	36,437
422	364	28,520
423	1,500	63,840
424	912	44,260
425	157	35,667
432	16,259	30,416
433	9,022	22,852
434	945	17,210
435	11,908	32,613
436	13,987	26,367
437	4,357	23,539
438	14,426	31,691
439	24,816	25,250
440	27,346	18,913
441	13,912	29,122
442	12,756	23,365
443	6,698	18,374
444	12,447	31,276
445	16,757	25,851
446	16,849	20,274
453	846	162,178
454	1,496	110,006
455	1,875	85,089
456	764	132,358
457	1,763	93,955
458	1,534	78,607
459	3,180	93,067
460	50,317	61,555
461	1,062	78,144
462	14,234	58,820
463	5,283	64,018
464	6,322	42,171
465	2,942	31,102
466	4,152	70,822
467	10,818	52,840
468	28,701	44,445
469	29,730	57,143
470	410,173	41,440
471	2,227	71,285
472	6,218	48,040
473	22,546	39,667
474	2,829	51,053
475	3,530	35,636
476	1,698	26,070
477	2,257	57,109
478	7,144	41,570
479	10,267	33,395
480	25,866	50,686
481	59,136	38,146
482	64,739	33,332
483	5,729	44,536
484	17,949	37,665
485	967	55,459
486	1,535	40,900
487	1,214	33,214
488	1,551	33,205
489	3,866	26,495
490	19,803	34,057
491	58,396	24,028
492	4,700	48,148
493	15,248	36,196
494	30,563	28,910
495	1,867	51,435
496	5,049	34,292
497	7,519	27,156
498	1,177	36,767
499	1,245	22,858
500	1,349	47,836
501	3,679	30,766
502	6,825	23,032
503	736	38,112
504	2,155	30,857
505	3,214	24,352
506	909	25,023
507	779	33,035
508	2,722	26,249
509	465	25,608
510	957	38,420
511	4,008	30,072
512	11,961	23,087
513	1,287	29,502
514	1,339	20,718
515	3,577	51,402
516	10,963	37,292
517	18,263	30,388
533	828	27,486
534	3,634	15,819
535	6,844	27,022
536	34,321	15,408
537	654	20,405
538	1,164	12,954
539	3,379	34,667
540	4,187	27,375
541	1,858	22,002
542	6,158	33,306
543	18,413	25,124
544	12,644	18,008
545	4,016	34,451
546	5,881	24,102
547	4,880	18,469
548	591	33,006
549	1,077	25,270
550	904	18,381
551	9,502	29,646
552	87,859	18,492
553	2,790	24,265
554	20,253	14,944
555	1,995	22,555
556	19,168	14,428
557	3,184	29,321
558	14,178	19,372
559	1,635	28,972
560	3,979	20,901
561	7,617	13,636
562	4,996	26,929
563	36,056	15,451
564	1,606	27,237
565	3,237	21,478
566	2,779	15,695
573	5,687	46,949
574	12,100	33,325
575	6,468	25,393
576	558	44,896
577	2,179	31,142
578	3,299	23,686
579	3,088	44,811
580	6,766	31,460
581	5,288	23,941
582	8,972	24,930
583	15,549	19,001
584	1,431	27,897
585	2,818	20,786
592	3,982	30,226
593	12,832	23,538
594	2,955	16,562
595	1,082	29,610
596	5,755	19,571
597	548	29,514
598	1,483	23,497
599	350	15,943
600	572	21,988
601	865	15,125
602	21,307	26,948
603	130,923	18,145
604	2,627	25,150
605	22,672	16,152
606	1,363	22,966
607	7,169	14,791
614	1,376	44,346
615	1,626	32,541
616	1,132	61,354
617	6,822	37,382
618	343	28,522
619	663	60,076
620	1,877	41,119
621	6,556	35,242
622	1,234	45,937
623	3,268	33,291
624	487	24,889
625	1,098	40,232
626	2,522	27,537
627	14,305	19,134
628	3,267	51,514
629	3,958	40,808
630	684	31,392
637	16,283	26,892
638	40,811	20,070
639	41,135	14,010
640	55,690	23,971
641	188,104	16,575
642	1,542	23,138
643	5,014	31,125
644	11,845	24,210
645	8,402	18,520
652	10,437	57,281
653	1,585	86,150
654	3,231	54,167
655	1,650	40,670
656	3,721	56,568
657	7,359	38,736
658	8,479	32,186
659	4,442	51,032
660	7,444	36,348
661	4,745	29,748
662	988	41,594
663	2,131	29,231
664	4,676	23,754
665	690	46,858
666	2,213	30,439
667	3,948	19,910
668	3,757	39,537
669	12,491	27,870
670	13,411	19,410
671	884	28,518
672	965	19,128
673	12,577	43,111
674	10,503	40,270
675	11,704	31,229
682	75,827	30,254
683	112,129	25,615
684	43,451	19,020
685	2,493	19,996
686	1,581	31,234
687	3,322	24,255
688	1,198	18,441
689	55,398	25,904
690	200,059	18,352
691	898	31,887
692	654	25,534
693	2,235	27,712
694	19,213	17,667
695	974	24,032
696	10,565	14,808
697	575	17,475
698	21,061	27,909
699	22,820	23,309
700	15,089	17,723
707	4,874	35,532
708	17,015	29,281
709	755	34,020
710	2,037	27,689
711	921	34,145
712	819	20,449
713	11,755	25,154
714	32,745	15,644
715	638	34,191
716	1,382	26,921
717	634	31,538
718	633	19,455
722	871	28,980
723	2,037	23,777
724	666	15,999
725	802	23,413
726	3,940	16,420
727	1,098	26,180
728	6,176	16,848
729	578	22,426
730	552	14,387
734	1,470	39,650
735	1,328	26,263
736	840	68,822
737	3,429	39,321
738	954	28,973
739	975	48,200
740	4,366	31,584
741	6,554	24,119
742	10,705	29,966
743	35,310	21,122
744	1,498	28,762
745	2,189	20,066
746	2,486	27,713
747	11,218	20,664
748	21,171	19,841
749	1,037	42,792
750	484	24,671
754	1,083	31,715
755	3,152	24,245
756	831	16,790
757	1,322	31,004
758	1,597	24,623
759	1,186	19,161
760	1,703	19,848
761	1,918	13,557
765	2,497	22,146
766	2,634	14,889
767	119	15,750
768	10	28,201
769	86	29,901
770	181	18,191
774	1,442	12,637
775	5,224	9,066
776	491	15,413
777	177	19,480
778	489	8,798
779	107	14,082
780	47	5,638
781	3,004	13,343
782	125	8,369
794	7	2,880
799	623	76,151
800	699	45,583
801	602	35,355
802	691	51,739
803	1,003	33,630
804	996	25,527
808	8,315	34,115
809	15,527	24,895
810	3,818	21,504
811	18,344	24,532
812	83,082	18,156
813	15,031	25,132
814	1,631	29,730
815	3,337	23,820
816	2,355	18,234
820	1,481	83,993
821	2,529	40,735
822	2,139	28,780
823	2,436	64,907
824	3,039	40,522
825	2,009	29,739
826	562	77,350
827	1,318	40,156
828	872	29,232
829	1,374	44,261
830	531	25,785
834	5,257	51,445
835	1,469	30,879
836	1,526	23,524
837	1,623	85,432
838	900	41,508
839	1,385	26,968
840	15,152	38,374
841	11,012	29,060
842	7,678	22,849
843	1,477	32,639
844	2,854	25,034
845	1,008	21,623
846	2,480	37,292
847	23,667	25,136
848	1,699	20,748
849	1,498	26,843
853	31,444	77,914
854	6,881	50,010
855	467	36,089
856	6,187	69,506
857	10,059	36,989
858	3,500	28,786
862	7,425	33,012
863	21,807	21,882
864	19,826	20,564
865	2,019	27,840
866	9,406	16,786
867	5,306	38,488
868	2,369	24,746
869	1,100	20,520
870	13,710	90,935
871	203,702	33,685
872	92,118	25,456
876	968	40,268
880	10,494	15,328
881	4,576	11,727
882	1,656	12,481
883	786	17,701
884	21,619	19,048
885	77,763	16,598
886	376	14,393
887	423	18,850
894	4,480	8,389
895	6,474	16,201
896	5,369	25,303
897	35,835	13,689
901	917	48,598
902	2,135	31,632
903	1,739	24,530
904	941	39,574
905	798	25,597
906	745	23,573
907	8,098	53,982
908	7,884	35,453
909	5,971	26,248
913	813	26,149
914	6,958	16,346
915	915	24,023
916	5,369	10,725
917	14,155	28,466
918	34,847	14,539
919	10,569	27,881
920	12,135	22,284
921	11,659	15,316
922	1,005	26,606
923	4,211	16,053
927	182	181,306
928	794	60,107
929	459	32,721
933	155	31,143
934	694	23,842
935	2,179	21,397
939	423	43,099
940	690	32,755
941	1,077	26,227
945	5,053	21,694
946	3,199	17,198
947	6,544	23,445
948	34,325	15,485
949	742	18,955
950	476	12,079
951	990	14,489
955	446	82,175
956	3,718	55,062
957	1,157	102,443
958	737	70,330
959	816	53,566
963	1,395	46,322
964	1,578	32,525
965	2,016	27,560
969	598	75,122
970	231	47,821
974	7,276	34,615
975	3,463	29,344
976	2,728	23,762
977	4,871	23,005
981	26,280	77,452
982	18,594	53,442
983	6,766	38,481
984	669	55,818
985	1,048	38,813
986	890	27,837
987	8,036	54,475
988	11,880	36,064
989	6,537	26,243
999	18	16,006

17. On pages 25118 through 25123, in Table I.—Impact Analysis of Proposed Changes For FY 2008, the listed entries and footnotes are corrected to read as follows:

18. On page 25124,

a. First column, second full paragraph, line 25, the figure “0.999317” is corrected to read “0.999367.”

b. Second column, last paragraph, line 3, the figure “0.999317” is corrected to read “0.999367.”

19. On page 25125,

a. First column, last paragraph, line 5, the figure “0.991938” is corrected to read “0.991925.”

b. Second column, first full paragraph, line 17, the figure “0.997084” is corrected to read “0.997080.”

20. On pages 25126 through 25128, in Table II.—Impact Analysis of Proposed Changes For FY 2008 Operating Prospective Payment System, the listed entries are corrected to read as follows:

Table II.—Impact Analysis of Proposed Changes for FY 2008 Operating Prospective Payment System (Payments per Case)

[Percent changes in payments per case]

	Number of hospitals	Published average proposed FY 2008 payment per case 1	Corrected average proposed FY 2008 payment per case 1	Published all proposed FY 2008 changes	Corrected all proposed FY 2008 changes
	(1)	(3)	(3)	(4)	(4)
All hospitals	3535	9299	9299	3.3	3.3
By Geographic Location:
Urban hospitals	2540	9678	9680	3.6	3.6
Large urban areas (populations over 1 million)	1409	10156	10157	4.2	4.2
Other urban areas (populations of 1 million or fewer)	1131	9103	9107	2.8	2.9
Rural hospitals	995	7123	7110	0.9	0.7
Bed Size (Urban):
0-99 beds	632	7263	7261	0.4	0.3
100-199 beds	849	8170	8159	3.4	3.2
200-299 beds	480	9120	9117	3.5	3.4
300-499 beds	412	10136	10143	4.0	4.0
500 or more beds	167	12234	12254	4.0	4.2
Bed Size (Rural):
0-49 beds	342	6065	6045	−1.6	−1.9
50-99 beds	369	6588	6572	0.5	0.2
100-149 beds	172	6960	6945	1.3	1.1
150-199 beds	67	7735	7727	1.4	1.3
200 or more beds	45	8938	8937	2.0	2.0
Urban by Region:
New England	126	10001	10004	2.6	2.6
Middle Atlantic	350	10529	10532	2.8	2.8
South Atlantic	388	9175	9176	4.2	4.3
East North Central	395	9197	9199	3.4	3.5
East South Central	166	8784	8786	3.2	3.2
West North Central	156	9321	9334	2.8	3.0
West South Central	358	9174	9175	4.0	4.0
Mountain	153	9826	9836	3.3	3.5
Pacific	395	11657	11656	4.7	4.7
Puerto Rico	53	4525	4511	3.6	3.3
Rural by Region:
New England	19	9714	9716	0.4	0.4
Middle Atlantic	72	7525	7514	0.8	0.6
South Atlantic	173	6700	6683	1.8	1.6
East North Central	124	7574	7567	0.7	0.6
East South Central	177	6479	6462	1.2	1.0
West North Central	115	7792	7786	0.6	0.6
West South Central	194	6339	6322	−0.7	−0.9
Mountain	80	7834	7822	0.9	0.7
Pacific	41	8896	8881	2.0	1.8
By Payment Classification:
Urban hospitals	2619	9629	9631	3.6	3.6
Large urban areas (populations over 1 million)	1436	10127	10128	4.1	4.1
Other urban areas (populations of 1 million or fewer)	1183	9034	9038	2.8	2.8
Rural areas	916	7242	7230	0.9	0.8
Teaching Status:
Non-teaching	2479	7851	7844	2.7	2.6
Fewer than 100 Residents	816	9384	9385	3.5	3.5
100 or more Residents	240	13533	13555	4.1	4.2
Urban DSH:
Non-DSH	879	8307	8314	2.0	2.1
100 or more beds	1527	10182	10183	4.0	4.0
Less than 100 beds	359	6697	6682	1.9	1.6
Rural DSH:
SCH	391	7013	6994	0.3	0.0
RRC	189	7818	7809	1.7	1.6
100 or more beds	36	6028	6010	2.1	1.8
Less than 100 beds	154	5353	5335	0.4	0.0
Urban teaching and DSH:
Both teaching and DSH	805	11185	11192	4.0	4.1
Teaching and no DSH	192	9078	9089	2.5	2.6
No teaching and DSH	1081	8283	8273	3.7	3.5
No teaching and no DSH	541	7812	7817	1.9	2.0
Rural Hospital Types:
RRC	59	8358	8359	2.5	2.5
SCH	45	9301	9296	0.8	0.8
MDH	21	6339	6319	0.3	0.0
SCH and RRC	17	10239	10236	2.7	2.7
MDH and RRC	1	9674	9677	−0.8	−0.8
Type of Ownership:
Voluntary	2069	9424	9427	3.2	3.2
Proprietary	823	8478	8471	3.7	3.6
Government	598	9593	9589	3.5	3.4
Medicare Utilization as a Percent of Inpatient Days:
0-25	230	13443	13434	5.6	5.5
25-50	1292	10570	10576	4.0	4.1
50-65	1453	8116	8113	2.6	2.5
Over 65	441	7331	7325	1.2	1.2
Hospitals Reclassified by the Medicare Geographic Classification Review Board: FY 2008 Reclassifications:
All Reclassified Hospitals FY 2008	801	8938	8937	2.8	2.8
All Non-Reclassified Hospitals FY 2008	2734	9417	9416	3.4	3.4
Urban Reclassified Hospitals FY 2008	434	9581	9595	3.3	3.4
Urban Non-reclassified Hospitals FY 2008	2105	9701	9705	3.6	3.7
Rural Reclassified Hospitals FY 2008	367	7669	7663	1.5	1.4
Rural Nonreclassified Hospitals FY 2008	568	6392	6374	−0.3	−0.6
All Section 401 Reclassified Hospitals	31	8799	8787	1.8	1.6
Other Reclassified Hospitals (Section 1886(d)(8)(B))	61	6729	6710	1.4	1.1
Former Section 508 Hospitals	107	9814	9823	0.5	0.6
Specialty Hospitals
Cardiac Specialty Hospitals	22	10676	10727	−0.6	−0.1
1 These payment amounts per case do not reflect any estimates of annual case-mix increase.

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

Dated: June 1, 2007.

Ann C. Agnew,

Executive Secretary to the Department.

Footnotes

1.  Cases taken from the FY 2006 MedPAR file; proposed MS-DRGs are from GROUPER Version 25.0.

6.  Shown here are the tentative effects of geographic reclassifications by the Medicare Geographic Classification Review Board (MGCRB). The effects demonstrate the FY 2008 payment impact of going from no reclassifications to the reclassifications scheduled to be in effect for FY 2008. Reclassification for prior years has no bearing on the payment impacts shown here. This column reflect the geographic budget neutrality factor of 0.991925.

7.  This column displays the effects of the proposed changes in the rural floor budget neutrality adjustment applied on the wage index instead of on the standardized amount. The column reflects a proposed rural floor budget neutrality factor of 0.997080.

11.  This column shows tentative changes in payments from FY 2007 to FY 2008 including a 0.976 case mix index adjustment for coding and documentation improvements that are anticipated with the adoption of the MS-DRGs prior to the assumed growth occurring. In incorporates all of the changes displayed in Columns 4, 5, 6, 7, 8, 9, 10 and (the changes displayed in Columns 2 and 3 are included in Column 4).

12.  This column shows tentative changes in payments from FY 2007 to FY 2008 with a case mix index adjustment and the assumed growth for improvements in documentation and coding. It incorporates all of the changes displayed in Columns 4, 5, 6, 7, 8, 9, 10 and (the changes displayed in Columns 2 and 3 are included in Column 4). It also reflects the impact of the proposed FY 2008 update, and changes in hospitals' reclassification status in FY 2008 compared to FY 2007. The sum of these impacts may be different from the percentage changes shown here due to rounding and interactive effects.