Proposed Rule: Medicare: Hospital Inpatient Prospective Payment Systems and 2008 FY Rates Correction

Federal Register / Vol. 72, No.
109 / Thursday, June 7, 2007 / Proposed Rules 31507
attainment for the 8-hour ozone SUPPLEMENTARY INFORMATION: corrected to read ‘‘in the FY 2006
NAAQS, the associated maintenance MedPAR.’’
I. Background
plan, the 2002 base-year inventory, and b. Fifth full paragraph, last line, after
the MVEBs identified in the In FR Doc. 07–1920 of May 3, 2007 the phrase ‘‘cost of living adjustment.’’,
maintenance plan, does not impose an (72 FR 24680), there were a number of the following sentence is added to read
information collection burden under the technical errors that are identified and as follows:
provisions of the Paperwork Reduction corrected in the Correction of Errors ‘‘Beginning with FY 2008, because
Act of 1995 (44 U.S.C. 3501 et seq.). section of this notice. We issued the hospital charges include charges for
fiscal year (FY) 2008 hospital inpatient both operating and capital costs, we are
List of Subjects prospective payment systems (IPPS) proposing to standardize total charges to
40 CFR Part 52 proposed rule on April 13, 2007. The FY remove the effects of differences in
2008 IPPS proposed rule appeared in geographic adjustment factors, large
Environmental protection, Air
the May 3, 2007 Federal Register. urban add-on payments, cost-of-living
pollution control, Nitrogen dioxide,
Ozone, Reporting and recordkeeping II. Summary of Errors adjustment, disproportionate share
requirements, Volatile organic payments, and IME adjustments under
We recently discovered that an error
compounds. the capital IPPS as well.’’
was made in the calculation of the DRG
relative weights presented in the FY 3. On page 24747, first column, third
40 CFR Part 81
2008 IPPS proposed rule. We have full paragraph, last line, after the phrase
Air pollution control, National parks, ‘‘cost of living adjustment.’’ and before
revised the relative weights to correct
Wilderness areas. the phrase ‘‘Charges were then’’, the
the error and have recalculated the
Authority: 42 U.S.C. 7401 et seq. standardized amounts. These changes following sentence is added to read as
Dated: May 31, 2007. increase the standardized amounts follows:
William T. Wisniewski, slightly and reduce the proposed FY ‘‘Beginning with FY 2008, because
2008 outlier threshold by $85. Further, hospital charges include charges for
Acting Regional Administrator, Region III.
these revisions affect the DRG-specific both operating and capital costs, we are
[FR Doc. E7–11019 Filed 6–6–07; 8:45 am]
costs thresholds for new technology proposing to standardize total charges to
BILLING CODE 6560–50–P
add-on payments. Therefore, in this remove the effects of differences in
notice we are correcting the following: geographic adjustment factors, large
• Preamble language regarding the urban add-on payments, cost-of-living
DEPARTMENT OF HEALTH AND methodology used to calculate charge- adjustment, disproportionate share
HUMAN SERVICES based and cost-based relative weights. payments, and IME adjustments under
• Outlier threshold. the capital IPPS as well.’’
Centers for Medicare & Medicaid
• Recalibration, wage and B. Corrections to the Addendum
Services
recalibration, geographic
reclassification, and rural floor budget 1. On page 24836,
42 CFR Parts 411, 412, 413, and 489
neutrality factors. a. First column, second full
[CMS–1533–CN] • Tables 1A through 1D, 2, 4A, 4C, 4J, paragraph,
RIN 0938–A070
5, 10. (1) Line 14, the figure ‘‘0.999317’’ is
• Impact analysis tables (Tables I and corrected to read ‘‘0.999367.’’
Medicare Program; Proposed Changes II). (2) Lines 19 and 29, the figure
to the Hospital Inpatient Prospective In addition, we have posted these ‘‘0.998557’’ is corrected to read
Payment Systems and Fiscal Year 2008 corrected tables on our Web site at ‘‘0.998573.’’
Rates; Correction http://www.cms.hhs.gov/ b. Second column, first partial
AcuteInpatientPPS/WIFN/list.asp. paragraph, line 17, the figure
AGENCY: Centers for Medicare &
Medicaid Services (CMS), HHS. III. Correction of Errors ‘‘0.991938’’ is corrected to read
ACTION: Correction of proposed rule.
‘‘0.991925.’’
In FR Doc. 07–1920 of May 3, 2007
(72 FR 24680), make the following 2. On page 24837, second column,
SUMMARY: This document corrects second full paragraph, line 6, the figure
corrections:
technical errors that appeared in the ‘‘$23,015’’ is corrected to read
proposed rule entitled ‘‘Medicare A. Corrections to the Preamble ‘‘$22,930’’.
Program; Proposed Changes to the 1. On page 24711, second column, last 3. On page 24839, top half of the page,
Hospital Inpatient Prospective Payment paragraph, sixth line from the bottom, in the table Comparison of FY 2007
Systems and Fiscal Year 2008 Rates’’ the figure ‘‘$23,015’’ is corrected to read Standardized Amounts to Proposed FY
that appeared in the May 3, 2007 ‘‘$22,930.’’ 2008 Single Standardized Amount with
Federal Register. 2. On page 24746, second column, Full Update and Reduced Update, the
FOR FURTHER INFORMATION CONTACT: a. Third full paragraph, line 9, the figures in the listed entries are corrected
Marc Hartstein, (410) 786–4548. phrase, ‘‘in the FY 2005 MedPAR’’ is to read as follows:
Reduced
Full update update
(3.3 percent) (1.3 percent)
jlentini on PROD1PC65 with PROPOSALS
FY 2008 DRG Recalibrations and Wage Index Budget Neutrality Factor .......................................................... 0.999367 0.999367
FY 2008 Reclassification Budget Neutrality Factor ............................................................................................. 0.991925 0.991925
VerDate Aug<31>2005 16:51 Jun 06, 2007 Jkt 211001 PO 00000 Frm 00035 Fmt 4702 Sfmt 4702 E:\FR\FM\07JNP1.SGM 07JNP1
31508 Federal Register / Vol. 72, No. 109 / Thursday, June 7, 2007 / Proposed Rules
4. On page 24846, third column, first column, last row, the figure, ‘‘$413.87’’ (2) Line 12, the figure ‘‘$195.60’’ is
full paragraph, is corrected to read ‘‘$413.73.’’ corrected to read ‘‘$195.51.’’
a. Line 38, the figure ‘‘$417.26’’ is b. Lower third of the page, in the table b. Second column, third paragraph,
corrected to read ‘‘$417.12.’’ Comparison of Factors and last line, the figure ‘‘$23,015’’ is
b. Line 40, the figure ‘‘$413.87’’ is Adjustments: FY 2007 Capital Federal corrected to read ‘‘$22,930’’.
corrected to read ‘‘$413.73.’’ Rate and Proposed FY 2008 Capital
Federal Rate for Rural Hospitals, third 7. On page 24850, in Table 1A.—
5. On page 24847, column, last row, the figure ‘‘$417.26’’ National Adjusted Operating
a. Middle of the page, in the table is corrected to read ‘‘$417.12.’’ Standardized Amounts, Labor/Nonlabor
Comparison of Factors and 6. On page 24848, (69.7 Percent Labor Share/30.3 Percent
Adjustments: FY 2007 Capital Federal a. First column, fourth full paragraph, Nonlabor Share If Wage Index Greater
Rate and Proposed FY 2008 Capital (1) Line 10, the phrase ‘‘is $197.21’’ is Than 1), the table is corrected to read as
Federal Rate for Urban Hospitals, third corrected to read ‘‘is $197.11.’’. 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 Reduced update
(3.3 percent) (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.— (62 Percent Labor Share/38 Percent Than Or Equal To 1), the table is
National Adjusted Operating Nonlabor Share If Wage Index Less corrected to read as follows:
Standardized Amounts, Labor/Nonlabor
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 Reduced update
(3.3 percent) (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.— Nonlabor, the table is corrected to read

Adjusted Operating Standardized as follows:
Amounts For Puerto Rico Labor, Labor/
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 Average Hourly Wages For Federal wage index for the listed provider
Table 2.—Hospital Case-Mix Indexes Fiscal Years 2006 (2002 Wage Data), numbers are corrected to read as
For Discharges Occurring in Federal 2007 (2003 Wage Data), And 2008 (2004 follows:
Fiscal Year 2006; Hospital Wage Indexes Wage Data); And 3-Year Average Of
For Federal Fiscal Year 2008; Hospital Hospital Average Hourly Wages, the
Federal Register / Vol. 72, No. 109 / Thursday, June 7, 2007 / Proposed Rules 31509
FY 2008 FY 2008 FY 2008

Provider No. Provider No. Provider No.
wage index wage index wage index
010012 ...................................... 0.9390 160030 ...................................... 1.0022 320079 ...................................... 0.9739

010047 ...................................... 0.7776 180013 ...................................... 0.9407 320083 ...................................... 0.9739
010052 ...................................... 0.7701 180064 ...................................... 0.8131 330135 ...................................... 1.1528
010109 ...................................... 0.8049 180066 ...................................... 0.9407 330205 ...................................... 1.1528
010110 ...................................... 0.7900 180079 ...................................... 0.8075 330264 ...................................... 1.1528
010164 ...................................... 0.8042 180080 ...................................... 0.8042 340133 ...................................... 0.8916
040014 ...................................... 0.8720 180124 ...................................... 0.9407 360044 ...................................... 0.8825
040017 ...................................... 0.8718 190044 ...................................... 0.7849 370113 ...................................... 0.8718
040041 ...................................... 0.8720 190190 ...................................... 0.7752 380029 ...................................... 1.0479
040071 ...................................... 0.8720 190246 ...................................... 0.7752 380051 ...................................... 1.0479
040076 ...................................... 0.8720 200032 ...................................... 0.8878 380056 ...................................... 1.0479
040078 ...................................... 0.8720 210028 ...................................... 0.9429 390044 ...................................... 1.0777
040100 ...................................... 0.8720 230036 ...................................... 0.9398 390096 ...................................... 1.0777
040119 ...................................... 0.8720 230041 ...................................... 0.9398 390133 ...................................... 1.0777
050007 ...................................... 1.4907 230047 ...................................... 1.0091 410013 ...................................... 1.1793
050008 ...................................... 1.4792 230080 ...................................... 0.9398 430012 ...................................... 0.9394
050009 ...................................... 1.4200 230105 ...................................... 0.9398 430013 ...................................... 0.9394
050013 ...................................... 1.4200 230195 ...................................... 1.0091 430048 ...................................... 0.8398
050016 ...................................... 1.2015 230204 ...................................... 1.0091 440011 ...................................... 0.8042
050047 ...................................... 1.4792 230222 ...................................... 0.9398 440015 ...................................... 0.8042
050055 ...................................... 1.4792 230227 ...................................... 1.0091 440019 ...................................... 0.8042
050070 ...................................... 1.4907 230257 ...................................... 1.0091 440030 ...................................... 0.7972
050113 ...................................... 1.4907 230264 ...................................... 1.0091 440034 ...................................... 0.8042
050152 ...................................... 1.4792 230297 ...................................... 1.0091 440035 ...................................... 0.9407
050228 ...................................... 1.4792 230299 ...................................... 1.0091 440056 ...................................... 0.8042
050232 ...................................... 1.2015 230300 ...................................... 1.0091 440073 ...................................... 0.9407
050280 ...................................... 1.2826 240006 ...................................... 1.0760 440084 ...................................... 0.7949
050289 ...................................... 1.4907 240010 ...................................... 1.0760 440110 ...................................... 0.8042
050407 ...................................... 1.4792 240018 ...................................... 1.0084 440120 ...................................... 0.8042
050454 ...................................... 1.4792 240061 ...................................... 1.0760 440125 ...................................... 0.8042
050457 ...................................... 1.4792 240069 ...................................... 1.0760 440144 ...................................... 0.9407
050506 ...................................... 1.2015 240071 ...................................... 1.0760 440148 ...................................... 0.9407
050633 ...................................... 1.2015 270081 ...................................... 0.8574 440151 ...................................... 0.9407
050667 ...................................... 1.4200 280065 ...................................... 0.9746 440153 ...................................... 0.7923
050668 ...................................... 1.4792 310010 ...................................... 1.0812 440173 ...................................... 0.8042
050697 ...................................... 1.2826 310011 ...................................... 1.0864 440175 ...................................... 0.9407
050707 ...................................... 1.4907 310014 ...................................... 1.0777 440192 ...................................... 0.9407
050733 ...................................... 1.2826 310044 ...................................... 1.0812 440225 ...................................... 0.8042
050754 ...................................... 1.4907 310081 ...................................... 1.0777 440226 ...................................... 0.8042
060010 ...................................... 0.9730 310092 ...................................... 1.0812 450370 ...................................... 0.8444
060030 ...................................... 0.9730 310110 ...................................... 1.0812 450565 ...................................... 0.8690
080001 ...................................... 1.0777 320001 ...................................... 0.9739 450755 ...................................... 0.8498
080003 ...................................... 1.0777 320005 ...................................... 0.9739
100102 ...................................... 0.8874 320006 ...................................... 0.9739 12. On pages 24924, 29426, and
100290 ...................................... 0.9331 320009 ...................................... 0.9739
24941, in Table 4A.—Wage Index and
110107 ...................................... 0.9752 320011 ...................................... 0.9407
110164 ...................................... 0.9752 320017 ...................................... 0.9739 Capital Geographic Adjustment Factor
110201 ...................................... 0.9752 320019 ...................................... 0.9739 (GAF) for Urban Areas by CBSA—FY
130066 ...................................... 0.9680 320021 ...................................... 0.9739 2008, the wage index and GAF for the
130068 ...................................... 0.9680 320037 ...................................... 0.9739 listed CBSAs are corrected to read as
150015 ...................................... 0.8904 320074 ...................................... 0.9739 follows:
Wage
CBSA code Urban area GAF
index
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 For Hospitals That Are Reclassified By GAFs for the listed areas are corrected
Table 4C.—Wage Index And Capital CBSA FY 2008, the wage indices and to read as follows:
Geographic Adjustment Factor (GAF)
Wage
CBSA code Area GAF
index
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 providers are corrected to read as

Table 4J.—Out-Migration Adjustment— follows:
FY 2008, the entries for the listed
Reclassified for Out-migration

Provider No. Qualifying county name County code
FY 2008 adjustment
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

FY 2008 adjustment
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

FY 2008 adjustment
510077 ...................................................... * 0.0021 MINGO ..................................................... 51290
15. On pages 24960 through 24977, in DRGs), Relative Weighting Factors, and of Stay, the table is corrected to read as
Table 5.—List of Proposed Medicare Geometric and Arithmetic Mean Length follows:
Severity-Diagnosis Related Groups (MS– BILLING CODE 4120–01–P
EP07JN07.000</GPH>
EP07JN07.001</GPH>
EP07JN07.002</GPH>
EP07JN07.003</GPH>
EP07JN07.004</GPH>
EP07JN07.005</GPH>
EP07JN07.006</GPH>
EP07JN07.007</GPH>
EP07JN07.008</GPH>
EP07JN07.009</GPH>
EP07JN07.010</GPH>
EP07JN07.011</GPH>
EP07JN07.012</GPH>
EP07JN07.013</GPH>
EP07JN07.014</GPH>
EP07JN07.015</GPH>
EP07JN07.016</GPH>
EP07JN07.017</GPH>
BILLING CODE 4120–01–C 16. On pages 25095 through 25099, in Lesser of .75 Of The National Adjusted
Table 10.—Geometric Mean Plus The Operating Standardized Payment
EP07JN07.018</GPH>
Amount (Increased To Reflect The Proposed Number of Proposed Number of

Threshold Threshold
Difference Between Costs And Charges) MS–DRG cases MS–DRG cases
Or .75 Of One Standard Deviation Of
Mean Charges By Proposed Medicare 77 .............. 1,101 32,854 180 ............ 22,474 32,948
Severity Diagnosis Related Group (MS– 78 .............. 1,307 24,933 181 ............ 32,156 26,822
79 .............. 957 20,523 182 ............ 6,163 22,468
DRG) April 2007,1 the table is corrected 80 .............. 2,077 24,135 183 ............ 1,654 29,694
to read as follows: 81 .............. 8,190 17,502 184 ............ 4,141 22,561
82 .............. 1,646 33,910 185 ............ 2,593 15,740
Proposed Number of 83 .............. 1,940 28,383 186 ............ 8,533 31,857
Threshold
MS–DRG cases 84 .............. 2,591 22,654 187 ............ 9,968 25,761
85 .............. 5,328 35,679 188 ............ 5,148 20,974
1 ................ 629 $337,776 86 .............. 10,382 26,404 189 ............ 104,531 28,757
2 ................ 328 177,459 87 .............. 12,152 20,144 190 ............ 57,041 27,770
3 ................ 23,999 266,199 88 .............. 717 30,107 191 ............ 121,659 24,280
4 ................ 21,742 162,448 89 .............. 2,641 23,706 192 ............ 196,903 18,419
5 ................ 842 159,506 90 .............. 3,319 17,874 193 ............ 88,053 29,668
6 ................ 495 90,877 91 .............. 6,676 29,690 194 ............ 266,599 24,679
7 ................ 413 130,276
92 .............. 14,890 22,313 195 ............ 147,744 18,274
8 ................ 560 92,482
93 .............. 15,484 17,172 196 ............ 5,143 30,999
9 ................ 1,358 96,148
94 .............. 1,521 56,938 197 ............ 6,894 25,721
10 .............. 177 72,498
95 .............. 1,088 42,964 198 ............ 4,943 21,129
11 .............. 1,289 71,569
96 .............. 755 36,338 199 ............ 3,257 33,231
12 .............. 1,923 51,377
97 .............. 1,252 51,314 200 ............ 8,185 23,984
13 .............. 1,484 36,890
98 .............. 1,048 35,977 201 ............ 3,523 17,676
20 .............. 901 138,451
99 .............. 642 30,167 202 ............ 31,587 20,635
21 .............. 558 107,625
22 .............. 251 74,547 100 ............ 15,837 28,714 203 ............ 41,587 15,003
23 .............. 3,112 81,762 101 ............ 56,905 19,341 204 ............ 26,039 17,394
24 .............. 2,576 60,740 102 ............ 1,352 24,321 205 ............ 5,775 26,368
25 .............. 8,417 79,522 103 ............ 15,023 17,133 206 ............ 22,415 18,854
26 .............. 11,626 52,970 113 ............ 568 31,544 207 ............ 46,165 83,212
27 .............. 14,454 41,141 114 ............ 601 21,640 208 ............ 79,432 41,398
28 .............. 1,609 73,994 115 ............ 1,098 25,563 215 ............ 150 151,502
29 .............. 2,862 45,280 116 ............ 665 23,828 216 ............ 8,411 165,422
30 .............. 3,751 30,578 117 ............ 1,400 16,827 217 ............ 7,609 118,088
31 .............. 1,057 59,862 121 ............ 587 22,514 218 ............ 3,256 98,470
32 .............. 2,987 35,341 122 ............ 674 13,518 219 ............ 10,062 132,460
33 .............. 4,263 30,562 123 ............ 2,843 19,108 220 ............ 13,481 94,478
34 .............. 813 58,045 124 ............ 679 24,153 221 ............ 8,383 81,144
35 .............. 2,506 42,020 125 ............ 4,705 16,568 222 ............ 2,865 149,784
36 .............. 7,710 36,365 129 ............ 1,374 37,663 223 ............ 5,770 116,219
37 .............. 4,777 51,688 130 ............ 1,072 28,539 224 ............ 1,919 138,213
38 .............. 14,602 33,107 131 ............ 655 35,824 225 ............ 5,871 109,030
39 .............. 55,357 25,687 132 ............ 728 27,050 226 ............ 7,048 112,464
40 .............. 4,549 58,682 133 ............ 1,352 31,142 227 ............ 50,536 88,444
41 .............. 7,720 39,547 134 ............ 2,661 20,306 228 ............ 3,084 126,976
42 .............. 5,430 34,186 135 ............ 781 35,301 229 ............ 4,128 89,139
52 .............. 1,156 29,433 136 ............ 1,113 24,451 230 ............ 1,989 73,311
53 .............. 593 22,836 137 ............ 1,108 28,410 231 ............ 1,478 138,287
54 .............. 4,664 30,610 138 ............ 1,370 20,587 232 ............ 1,795 107,403
55 .............. 16,896 24,934 139 ............ 2,145 22,300 233 ............ 16,911 119,988
56 .............. 7,716 29,072 146 ............ 687 35,060 234 ............ 39,167 86,734
57 .............. 48,432 19,657 147 ............ 1,422 25,142 235 ............ 9,628 97,022
58 .............. 789 28,525 148 ............ 935 18,944 236 ............ 32,871 68,172
59 .............. 2,639 22,939 149 ............ 39,248 15,883 237 ............ 21,789 85,211
60 .............. 4,201 17,679 150 ............ 939 25,105 238 ............ 44,929 53,794
61 .............. 1,340 53,318 151 ............ 6,801 13,607 239 ............ 13,814 64,168
62 .............. 2,288 41,979 152 ............ 2,352 22,958 240 ............ 13,349 43,051
63 .............. 1,185 36,186 153 ............ 16,028 15,145 241 ............ 3,350 31,297
64 .............. 55,552 34,358 154 ............ 1,843 27,851 242 ............ 17,179 64,273
65 .............. 112,189 27,004 155 ............ 4,207 22,020 243 ............ 37,856 50,218
66 .............. 94,547 21,586 156 ............ 5,140 16,103 244 ............ 68,201 42,102
67 .............. 1,383 30,616 157 ............ 1,145 28,232 245 ............ 6,241 54,054
68 .............. 12,393 23,506 158 ............ 3,039 21,662 246 ............ 32,661 64,613
69 .............. 103,747 18,936 159 ............ 2,418 15,345 247 ............ 279,972 46,787
70 .............. 7,092 34,031 163 ............ 13,431 79,829 248 ............ 5,013 58,218
71 .............. 10,001 26,444 164 ............ 18,047 47,971 249 ............ 29,657 41,876
72 .............. 6,056 20,628 165 ............ 14,553 37,942 250 ............ 5,739 53,408
73 .............. 8,655 26,844 166 ............ 20,290 58,779 251 ............ 39,905 38,200
167 ............ 20,772 40,117 252 ............ 44,602 48,168
74 .............. 32,523 21,427

75 .............. 1,197 33,931 168 ............ 5,758 30,294 253 ............ 46,864 43,475
76 .............. 874 24,318 175 ............ 11,954 33,475 254 ............ 59,029 34,550
176 ............ 40,173 26,670 255 ............ 2,609 39,961
1 Cases taken from the FY 2006 MedPAR file; 177 ............ 57,179 36,617 256 ............ 3,833 30,250
proposed MS–DRGs are from GROUPER Version 178 ............ 71,192 30,381 257 ............ 774 23,818
25.0. 179 ............ 27,454 24,673 258 ............ 598 49,682
Proposed Number of Proposed Number of Proposed Number of

Threshold Threshold Threshold
MS–DRG cases MS–DRG cases MS–DRG cases
259 ............ 7,328 35,034 356 ............ 8,366 58,953 459 ............ 3,180 93,067
260 ............ 867 47,446 357 ............ 8,046 40,130 460 ............ 50,317 61,555
261 ............ 2,804 28,303 358 ............ 2,714 31,167 461 ............ 1,062 78,144
262 ............ 3,378 23,301 368 ............ 3,052 31,502 462 ............ 14,234 58,820
263 ............ 788 29,053 369 ............ 4,005 25,728 463 ............ 5,283 64,018
264 ............ 30,137 39,708 370 ............ 3,914 20,084 464 ............ 6,322 42,171
280 ............ 60,735 36,717 371 ............ 16,843 32,446 465 ............ 2,942 31,102
281 ............ 57,734 28,584 372 ............ 22,903 26,907 466 ............ 4,152 70,822
282 ............ 60,951 23,031 373 ............ 14,897 20,598 467 ............ 10,818 52,840
283 ............ 15,852 30,928 374 ............ 9,414 34,760 468 ............ 28,701 44,445
284 ............ 4,911 23,409 375 ............ 19,730 26,563 469 ............ 29,730 57,143
285 ............ 3,254 17,351 376 ............ 4,816 22,403 470 ............ 410,173 41,440
286 ............ 23,282 40,266 377 ............ 50,503 30,943 471 ............ 2,227 71,285
287 ............ 172,488 28,923 378 ............ 84,806 24,936 472 ............ 6,218 48,040
288 ............ 3,245 50,617 379 ............ 128,748 19,140 473 ............ 22,546 39,667
289 ............ 1,423 36,464 380 ............ 2,917 32,583 474 ............ 2,829 51,053
290 ............ 484 28,249 381 ............ 4,894 26,915 475 ............ 3,530 35,636
291 ............ 183,774 29,157 382 ............ 5,445 20,581 476 ............ 1,698 26,070
292 ............ 217,052 24,421 383 ............ 1,303 28,065 477 ............ 2,257 57,109
293 ............ 226,688 17,810 384 ............ 8,664 21,556 478 ............ 7,144 41,570
294 ............ 1,704 21,989 385 ............ 2,107 33,476 479 ............ 10,267 33,395
295 ............ 1,658 13,805 386 ............ 7,221 25,067 480 ............ 25,866 50,686
296 ............ 1,730 26,654 387 ............ 5,230 20,543 481 ............ 59,136 38,146
297 ............ 943 20,306 388 ............ 18,267 29,699 482 ............ 64,739 33,332
298 ............ 554 12,889 389 ............ 46,328 23,347 483 ............ 5,729 44,536
299 ............ 17,443 28,063 390 ............ 48,052 16,336 484 ............ 17,949 37,665
300 ............ 46,820 21,997 391 ............ 47,511 24,761 485 ............ 967 55,459
301 ............ 39,910 15,712 392 ............ 306,515 17,829 486 ............ 1,535 40,900
302 ............ 7,873 23,741 393 ............ 23,917 28,925 487 ............ 1,214 33,214
303 ............ 81,458 15,192 394 ............ 45,952 23,434 488 ............ 1,551 33,205
304 ............ 2,084 24,110 395 ............ 26,460 17,594 489 ............ 3,866 26,495
305 ............ 35,646 15,139 405 ............ 3,903 83,940 490 ............ 19,803 34,057
306 ............ 1,379 27,644 406 ............ 5,241 49,125 491 ............ 58,396 24,028
307 ............ 6,447 18,857 407 ............ 2,310 36,497 492 ............ 4,700 48,148
308 ............ 33,528 27,255 408 ............ 1,644 67,203 493 ............ 15,248 36,196
309 ............ 79,751 20,827 409 ............ 1,713 46,400 494 ............ 30,563 28,910
310 ............ 160,738 14,816 410 ............ 722 35,648 495 ............ 1,867 51,435
311 ............ 24,867 13,364 411 ............ 978 65,359 496 ............ 5,049 34,292
312 ............ 169,247 18,273 412 ............ 1,063 47,834 497 ............ 7,519 27,156
313 ............ 220,769 14,894 413 ............ 881 37,325 498 ............ 1,177 36,767
314 ............ 60,053 30,750 414 ............ 5,596 59,660 499 ............ 1,245 22,858
315 ............ 30,730 23,629 415 ............ 6,847 40,610 500 ............ 1,349 47,836
316 ............ 20,101 16,823 416 ............ 6,222 30,251 501 ............ 3,679 30,766
326 ............ 11,567 88,786 417 ............ 16,671 46,291 502 ............ 6,825 23,032
327 ............ 10,901 49,818 418 ............ 27,563 36,466 503 ............ 736 38,112
328 ............ 9,333 32,074 419 ............ 38,264 28,533 504 ............ 2,155 30,857
329 ............ 48,135 80,371 420 ............ 714 61,258 505 ............ 3,214 24,352
330 ............ 66,303 47,127 421 ............ 1,091 36,437 506 ............ 909 25,023
331 ............ 31,391 35,021 422 ............ 364 28,520 507 ............ 779 33,035
332 ............ 1,890 74,102 423 ............ 1,500 63,840 508 ............ 2,722 26,249
333 ............ 6,196 46,130 424 ............ 912 44,260 509 ............ 465 25,608
334 ............ 4,023 34,266 425 ............ 157 35,667 510 ............ 957 38,420
335 ............ 7,161 68,407 432 ............ 16,259 30,416 511 ............ 4,008 30,072
336 ............ 12,516 43,200 433 ............ 9,022 22,852 512 ............ 11,961 23,087
337 ............ 8,835 32,563 434 ............ 945 17,210 513 ............ 1,287 29,502
338 ............ 1,499 58,047 435 ............ 11,908 32,613 514 ............ 1,339 20,718
339 ............ 3,192 39,795 436 ............ 13,987 26,367 515 ............ 3,577 51,402
340 ............ 3,607 30,753 437 ............ 4,357 23,539 516 ............ 10,963 37,292
341 ............ 874 42,806 438 ............ 14,426 31,691 517 ............ 18,263 30,388
342 ............ 2,536 31,921 439 ............ 24,816 25,250 533 ............ 828 27,486
343 ............ 6,875 24,258 440 ............ 27,346 18,913 534 ............ 3,634 15,819
344 ............ 898 51,426 441 ............ 13,912 29,122 535 ............ 6,844 27,022
345 ............ 2,915 33,636 442 ............ 12,756 23,365 536 ............ 34,321 15,408
346 ............ 2,909 27,779 443 ............ 6,698 18,374 537 ............ 654 20,405
347 ............ 1,568 36,443 444 ............ 12,447 31,276 538 ............ 1,164 12,954
348 ............ 3,985 27,800 445 ............ 16,757 25,851 539 ............ 3,379 34,667
349 ............ 5,787 19,265 446 ............ 16,849 20,274 540 ............ 4,187 27,375
350 ............ 1,669 41,035 453 ............ 846 162,178 541 ............ 1,858 22,002
351 ............ 3,997 28,329 454 ............ 1,496 110,006 542 ............ 6,158 33,306
352 ............ 8,419 19,894 455 ............ 1,875 85,089 543 ............ 18,413 25,124
353 ............ 3,182 44,303 456 ............ 764 132,358 544 ............ 12,644 18,008
354 ............ 9,118 30,612 457 ............ 1,763 93,955 545 ............ 4,016 34,451
355 ............ 17,451 23,281 458 ............ 1,534 78,607 546 ............ 5,881 24,102

547 ............ 4,880 18,469 644 ............ 11,845 24,210 741 ............ 6,554 24,119
548 ............ 591 33,006 645 ............ 8,402 18,520 742 ............ 10,705 29,966
549 ............ 1,077 25,270 652 ............ 10,437 57,281 743 ............ 35,310 21,122
550 ............ 904 18,381 653 ............ 1,585 86,150 744 ............ 1,498 28,762
551 ............ 9,502 29,646 654 ............ 3,231 54,167 745 ............ 2,189 20,066
552 ............ 87,859 18,492 655 ............ 1,650 40,670 746 ............ 2,486 27,713
553 ............ 2,790 24,265 656 ............ 3,721 56,568 747 ............ 11,218 20,664
554 ............ 20,253 14,944 657 ............ 7,359 38,736 748 ............ 21,171 19,841
555 ............ 1,995 22,555 658 ............ 8,479 32,186 749 ............ 1,037 42,792
556 ............ 19,168 14,428 659 ............ 4,442 51,032 750 ............ 484 24,671
557 ............ 3,184 29,321 660 ............ 7,444 36,348 754 ............ 1,083 31,715
558 ............ 14,178 19,372 661 ............ 4,745 29,748 755 ............ 3,152 24,245
559 ............ 1,635 28,972 662 ............ 988 41,594 756 ............ 831 16,790
560 ............ 3,979 20,901 663 ............ 2,131 29,231 757 ............ 1,322 31,004
561 ............ 7,617 13,636 664 ............ 4,676 23,754 758 ............ 1,597 24,623
562 ............ 4,996 26,929 665 ............ 690 46,858 759 ............ 1,186 19,161
563 ............ 36,056 15,451 666 ............ 2,213 30,439 760 ............ 1,703 19,848
564 ............ 1,606 27,237 667 ............ 3,948 19,910 761 ............ 1,918 13,557
565 ............ 3,237 21,478 668 ............ 3,757 39,537 765 ............ 2,497 22,146
566 ............ 2,779 15,695 669 ............ 12,491 27,870 766 ............ 2,634 14,889
573 ............ 5,687 46,949 670 ............ 13,411 19,410 767 ............ 119 15,750
574 ............ 12,100 33,325 671 ............ 884 28,518 768 ............ 10 28,201
575 ............ 6,468 25,393 672 ............ 965 19,128 769 ............ 86 29,901
576 ............ 558 44,896 673 ............ 12,577 43,111 770 ............ 181 18,191
577 ............ 2,179 31,142 674 ............ 10,503 40,270 774 ............ 1,442 12,637
578 ............ 3,299 23,686 675 ............ 11,704 31,229 775 ............ 5,224 9,066
579 ............ 3,088 44,811 682 ............ 75,827 30,254 776 ............ 491 15,413
580 ............ 6,766 31,460 683 ............ 112,129 25,615 777 ............ 177 19,480
581 ............ 5,288 23,941 684 ............ 43,451 19,020 778 ............ 489 8,798
582 ............ 8,972 24,930 685 ............ 2,493 19,996 779 ............ 107 14,082
583 ............ 15,549 19,001 686 ............ 1,581 31,234 780 ............ 47 5,638
584 ............ 1,431 27,897 687 ............ 3,322 24,255 781 ............ 3,004 13,343
585 ............ 2,818 20,786 688 ............ 1,198 18,441 782 ............ 125 8,369
592 ............ 3,982 30,226 689 ............ 55,398 25,904 794 ............ 7 2,880
593 ............ 12,832 23,538 690 ............ 200,059 18,352 799 ............ 623 76,151
594 ............ 2,955 16,562 691 ............ 898 31,887 800 ............ 699 45,583
595 ............ 1,082 29,610 692 ............ 654 25,534 801 ............ 602 35,355
596 ............ 5,755 19,571 693 ............ 2,235 27,712 802 ............ 691 51,739
597 ............ 548 29,514 694 ............ 19,213 17,667 803 ............ 1,003 33,630
598 ............ 1,483 23,497 695 ............ 974 24,032 804 ............ 996 25,527
599 ............ 350 15,943 696 ............ 10,565 14,808 808 ............ 8,315 34,115
600 ............ 572 21,988 697 ............ 575 17,475 809 ............ 15,527 24,895
601 ............ 865 15,125 698 ............ 21,061 27,909 810 ............ 3,818 21,504
602 ............ 21,307 26,948 699 ............ 22,820 23,309 811 ............ 18,344 24,532
603 ............ 130,923 18,145 700 ............ 15,089 17,723 812 ............ 83,082 18,156
604 ............ 2,627 25,150 707 ............ 4,874 35,532 813 ............ 15,031 25,132
605 ............ 22,672 16,152 708 ............ 17,015 29,281 814 ............ 1,631 29,730
606 ............ 1,363 22,966 709 ............ 755 34,020 815 ............ 3,337 23,820
607 ............ 7,169 14,791 710 ............ 2,037 27,689 816 ............ 2,355 18,234
614 ............ 1,376 44,346 711 ............ 921 34,145 820 ............ 1,481 83,993
615 ............ 1,626 32,541 712 ............ 819 20,449 821 ............ 2,529 40,735
616 ............ 1,132 61,354 713 ............ 11,755 25,154 822 ............ 2,139 28,780
617 ............ 6,822 37,382 714 ............ 32,745 15,644 823 ............ 2,436 64,907
618 ............ 343 28,522 715 ............ 638 34,191 824 ............ 3,039 40,522
619 ............ 663 60,076 716 ............ 1,382 26,921 825 ............ 2,009 29,739
620 ............ 1,877 41,119 717 ............ 634 31,538 826 ............ 562 77,350
621 ............ 6,556 35,242 718 ............ 633 19,455 827 ............ 1,318 40,156
622 ............ 1,234 45,937 722 ............ 871 28,980 828 ............ 872 29,232
623 ............ 3,268 33,291 723 ............ 2,037 23,777 829 ............ 1,374 44,261
624 ............ 487 24,889 724 ............ 666 15,999 830 ............ 531 25,785
625 ............ 1,098 40,232 725 ............ 802 23,413 834 ............ 5,257 51,445
626 ............ 2,522 27,537 726 ............ 3,940 16,420 835 ............ 1,469 30,879
627 ............ 14,305 19,134 727 ............ 1,098 26,180 836 ............ 1,526 23,524
628 ............ 3,267 51,514 728 ............ 6,176 16,848 837 ............ 1,623 85,432
629 ............ 3,958 40,808 729 ............ 578 22,426 838 ............ 900 41,508
630 ............ 684 31,392 730 ............ 552 14,387 839 ............ 1,385 26,968
637 ............ 16,283 26,892 734 ............ 1,470 39,650 840 ............ 15,152 38,374
638 ............ 40,811 20,070 735 ............ 1,328 26,263 841 ............ 11,012 29,060
639 ............ 41,135 14,010 736 ............ 840 68,822 842 ............ 7,678 22,849
640 ............ 55,690 23,971 737 ............ 3,429 39,321 843 ............ 1,477 32,639
641 ............ 188,104 16,575 738 ............ 954 28,973 844 ............ 2,854 25,034
642 ............ 1,542 23,138 739 ............ 975 48,200 845 ............ 1,008 21,623
643 ............ 5,014 31,125 740 ............ 4,366 31,584 846 ............ 2,480 37,292

847 ............ 23,667 25,136 902 ............ 2,135 31,632 951 ............ 990 14,489
848 ............ 1,699 20,748 903 ............ 1,739 24,530 955 ............ 446 82,175
849 ............ 1,498 26,843 904 ............ 941 39,574 956 ............ 3,718 55,062
853 ............ 31,444 77,914 905 ............ 798 25,597 957 ............ 1,157 102,443
854 ............ 6,881 50,010 906 ............ 745 23,573 958 ............ 737 70,330
855 ............ 467 36,089 907 ............ 8,098 53,982 959 ............ 816 53,566
856 ............ 6,187 69,506 908 ............ 7,884 35,453 963 ............ 1,395 46,322
857 ............ 10,059 36,989 909 ............ 5,971 26,248 964 ............ 1,578 32,525
858 ............ 3,500 28,786 913 ............ 813 26,149 965 ............ 2,016 27,560
862 ............ 7,425 33,012 914 ............ 6,958 16,346 969 ............ 598 75,122
863 ............ 21,807 21,882 915 ............ 915 24,023 970 ............ 231 47,821
864 ............ 19,826 20,564 916 ............ 5,369 10,725 974 ............ 7,276 34,615
865 ............ 2,019 27,840 917 ............ 14,155 28,466 975 ............ 3,463 29,344
866 ............ 9,406 16,786 918 ............ 34,847 14,539 976 ............ 2,728 23,762
867 ............ 5,306 38,488 919 ............ 10,569 27,881 977 ............ 4,871 23,005
868 ............ 2,369 24,746 920 ............ 12,135 22,284 981 ............ 26,280 77,452
869 ............ 1,100 20,520 921 ............ 11,659 15,316 982 ............ 18,594 53,442
870 ............ 13,710 90,935 922 ............ 1,005 26,606 983 ............ 6,766 38,481
871 ............ 203,702 33,685 923 ............ 4,211 16,053 984 ............ 669 55,818
872 ............ 92,118 25,456 927 ............ 182 181,306 985 ............ 1,048 38,813
876 ............ 968 40,268 928 ............ 794 60,107
986 ............ 890 27,837
880 ............ 10,494 15,328 929 ............ 459 32,721
987 ............ 8,036 54,475
881 ............ 4,576 11,727 933 ............ 155 31,143
988 ............ 11,880 36,064
882 ............ 1,656 12,481 934 ............ 694 23,842
989 ............ 6,537 26,243
883 ............ 786 17,701 935 ............ 2,179 21,397
884 ............ 21,619 19,048 939 ............ 423 43,099 999 ............ 18 16,006
885 ............ 77,763 16,598 940 ............ 690 32,755
886 ............ 376 14,393 941 ............ 1,077 26,227 17. On pages 25118 through 25123, in
887 ............ 423 18,850 945 ............ 5,053 21,694 Table I.—Impact Analysis of Proposed
894 ............ 4,480 8,389 946 ............ 3,199 17,198 Changes For FY 2008, the listed entries
895 ............ 6,474 16,201 947 ............ 6,544 23,445 and footnotes are corrected to read as
896 ............ 5,369 25,303 948 ............ 34,325 15,485
897 ............ 35,835 13,689 949 ............ 742 18,955
follows:
901 ............ 917 48,598 950 ............ 476 12,079 BILLING CODE 4120–01–P
EP07JN07.019</GPH>
EP07JN07.020</GPH>
BILLING CODE 4120–01–C

reflect the geographic budget neutrality factor of documentation improvements that are anticipated
18. On page 25124, 0.991925. with the adoption of the MS–DRGs prior to the
7 This column displays the effects of the proposed assumed growth occurring. In incorporates all of the
6 Shown here are the tentative effects of changes in the rural floor budget neutrality changes displayed in Columns 4, 5, 6, 7, 8, 9, 10
geographic reclassifications by the Medicare adjustment applied on the wage index instead of on and (the changes displayed in Columns 2 and 3 are
Geographic Classification Review Board (MGCRB). the standardized amount. The column reflects a included in Column 4).
The effects demonstrate the FY 2008 payment proposed rural floor budget neutrality factor of 12 This column shows tentative changes in
impact of going from no reclassifications to the 0.997080. payments from FY 2007 to FY 2008 with a case mix
reclassifications scheduled to be in effect for FY 11 This column shows tentative changes in
index adjustment and the assumed growth for
2008. Reclassification for prior years has no bearing payments from FY 2007 to FY 2008 including a improvements in documentation and coding. It
EP07JN07.021</GPH>
on the payment impacts shown here. This column 0.976 case mix index adjustment for coding and incorporates all of the changes displayed in
a. First column, second full 19. On page 25125, ‘‘0.997084’’ is corrected to read
paragraph, line 25, the figure a. First column, last paragraph, line 5, ‘‘0.997080.’’
‘‘0.999317’’ is corrected to read the figure ‘‘0.991938’’ is corrected to 20. On pages 25126 through 25128, in
‘‘0.999367.’’ read ‘‘0.991925.’’ Table II.—Impact Analysis of Proposed
b. Second column, last paragraph, line Changes For FY 2008 Operating
3, the figure ‘‘0.999317’’ is corrected to b. Second column, first full Prospective Payment System, the listed
read ‘‘0.999367.’’ paragraph, line 17, the figure 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]
Published av- Corrected av-

erage pro- erage pro- Published all Corrected all
Number of posed FY posed FY proposed FY proposed FY
hospitals 2008 payment 2008 payment 2008 changes 2008 changes
per case 1 per case 1
(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
Columns 4, 5, 6, 7, 8, 9, 10 and (the changes proposed FY 2008 update, and changes in hospitals’ from the percentage changes shown here due to
displayed in Columns 2 and 3 are included in reclassification status in FY 2008 compared to FY rounding and interactive effects.
Column 4). It also reflects the impact of the 2007. The sum of these impacts may be different
TABLE II.—IMPACT ANALYSIS OF PROPOSED CHANGES FOR FY 2008 OPERATING PROSPECTIVE PAYMENT SYSTEM
(PAYMENTS PER CASE)—Continued
[Percent changes in payments per case]
Published av- Corrected av-

erage pro- erage pro- Published all Corrected all
Number of posed FY posed FY proposed FY proposed FY
hospitals 2008 payment 2008 payment 2008 changes 2008 changes
per case 1 per case 1
(1) (3) (3) (4) (4)
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 Classi-
fication 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 DEPARTMENT OF HOMELAND Flood Elevations (BFEs) and proposed
Program No. 93.773, Medicare—Hospital SECURITY BFEs modifications for the communities
Insurance; and Program No. 93.774, listed below. The BFEs are the basis for
Medicare—Supplementary Medical Federal Emergency Management the floodplain management measures
Insurance Program) Agency that the community is required either to
Dated: June 1, 2007. adopt or to show evidence of being
Ann C. Agnew, 44 CFR Part 67 already in effect in order to qualify or
Executive Secretary to the Department. [Docket No. FEMA–D–7800] remain qualified for participation in the
[FR Doc. 07–2806 Filed 6–1–07; 2:04 pm] National Flood Insurance Program
BILLING CODE 4120–01–P Proposed Flood Elevation (NFIP).
Determinations DATES: The comment period is ninety
AGENCY: Federal Emergency (90) days following the second
publication of this proposed rule in a
Management Agency, DHS.

newspaper of local circulation in each
ACTION: Proposed rule.
community.
SUMMARY: Technical information or ADDRESSES: The proposed BFEs for each
comments are requested on the community are available for inspection
proposed Base (1% annual chance) at the office of the Chief Executive

Proposed Rule: Medicare: Hospital Inpatient Prospective Payment Systems and 2008 FY Rates Correction

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Federal Register / Vol. 72, No.

109 / Thursday, June 7, 2007 / Proposed Rules 31507

Labor-related Nonlabor-related Labor-related Nonlabor-related

$3,430.41 $1,491.27 $3,363.99 $1,462.40

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.— Nonlabor, the table is corrected to read

TABLE 1C.—ADJUSTED OPERATING STANDARDIZED AMOUNTS FOR PUERTO RICO, LABOR/NONLABOR

Labor Nonlabor Labor Nonlabor

National ........ $3,430.41 $1,491.27 $3,363.99 $1,462.40

10. On page 24850, in Table 1D.—

TABLE 1D.—CAPITAL STANDARD FEDERAL PAYMENT RATE

National ........ $413.73 $417.12

FY 2008 FY 2008 FY 2008

010012 ...................................... 0.9390 160030 ...................................... 1.0022 320079 ...................................... 0.9739

10740 ....... Albuquerque, NM .............................................................................................................................................. 0.9739 0.9821

10740 ....... Albuquerque, NM .............................................................................................................................................. 0.9739 0.9821

14. On pages 24952 through 24960, in providers are corrected to read as

Reclassified for Out-migration

010009 ...................................................... * 0.0092 MORGAN ................................................. 01510

140167 ...................................................... * 0.1055 IROQUOIS ................................................ 14460

Reclassified for Out-migration

180064 ...................................................... ............................ 0.0319 MONTGOMERY ....................................... 18860

450393 ...................................................... * 0.0132 GRAYSON ................................................ 45564

Reclassified for Out-migration

510077 ...................................................... * 0.0021 MINGO ..................................................... 51290

Amount (Increased To Reflect The Proposed Number of Proposed Number of

74 .............. 32,523 21,427

Proposed Number of Proposed Number of Proposed Number of

Proposed Number of Proposed Number of Proposed Number of

Proposed Number of Proposed Number of Proposed Number of

BILLING CODE 4120–01–C

Published av- Corrected av-

(1) (3) (3) (4) (4)

All hospitals .......................................................................... 3535 9299 9299 3.3 3.3

Published av- Corrected av-

(1) (3) (3) (4) (4)

Management Agency, DHS.

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