[Federal Register Volume 66, Number 250 (Monday, December 31, 2001)]
[Rules and Regulations]
[Pages 67494-67495]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-32091]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 413, 419, and 489
[CMS-1159-F3]
RIN 0938-AL35
Medicare Program; Prospective Payment System for Hospital
Outpatient Services; Delay in Effective Date of Calendar Year 2002
Payment Rates and the Pro Rata Reduction on Transitional Pass-Through
Payments
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Final rule; delay of effective date.
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SUMMARY: This document delays the effective date of the payment rates
announced for Medicare hospital outpatient services paid under the
prospective payment system for calendar year 2002. These rates were
announced in a November 30, 2001 final rule (66 FR 59856). In addition,
this document delays the effective date of the uniform reduction to be
applied to each of the transitional pass-through payments for CY 2002.
Certain provisions of the November 30, 2001 rule, as discussed in the
SUPPLEMENTARY INFORMATION section, are not delayed.
DATES: The effective date of the amendments to 42 CFR published at 66
FR 59856 (November 30, 2001) remains January 1, 2002, except that the
effective date for Sec. 419.32(b)(1)(iii) is delayed indefinitely.
Also, the effective date for Sec. 419.62(d), added at 66 FR 55865,
published on November 2, 2001, is delayed indefinitely. The effective
date of the payment rates announced for Medicare hospital outpatient
services paid under the prospective payment system for calendar year
2002, published in the preamble and addenda of the November 30, 2001
final rule, and the uniform reduction to be applied to each of the
transitional pass-through payments for CY 2002, published in the
preamble and addenda of the November 30, 2001 final rule, is delayed
until no later than April 1, 2002. These rates were announced in a
November 30, 2001 final rule (66 FR 59856). We will publish a document
in the Federal Register announcing the new effective date for the rates
and for Sec. 419.32(b)(1)(iii) and Sec. 419.62(d).
FOR FURTHER INFORMATION CONTACT: James L. Hart, (410) 786-0378.
SUPPLEMENTARY INFORMATION:
Availability of Copies and Electronic Access
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Government Printing Office. The Website address is: http://www.access.gpo.gov/nara/index.html.
I. Background
On November 30, 2001, we published a final rule announcing the
final ambulatory payment classification (APC) groups, relative weights,
and payment rates under the hospital outpatient prospective payment
system (OPPS) for calendar year 2002 (66 FR 59856). As discussed in
detail in that document, in setting the APC relative weights, we
incorporated 75 percent of the estimated costs for devices eligible for
transitional pass-through payments in 2002 into the costs of the APC
groups associated with the use of the devices (66 FR 59906).
After the publication of the November 30 final rule, we discovered
that the final rule reflects several inadvertent technical errors in
which we incorrectly associated specific devices approved for
transitional pass-through payments with particular procedures. The
effects of the errors we have identified are of a magnitude significant
enough to affect not only the estimate of total transitional pass-
through payments and the uniform reduction percentage to be applied to
transitional pass-through payments in 2002, but also the payment rates
for all APCs. Using rates that reflect these errors would result in
inappropriate, uneven effects on payments to hospitals. Thus, we
believe it would be inappropriate to proceed to make the payment rates
published on November 30 effective without further changes.
In order to thoroughly assess the accuracy of the data files
containing these errors and to assure that they do not contain further
errors that might also have significant implications, an intensive
review of the data will be necessary. Because of the time needed for
this review, we cannot complete this review and recalculate the rates
before the previously published effective date of January 1, 2002. We
will, therefore, continue to pay for services covered under the OPPS
after January 1 and until no later than April 1, 2002 under the rates
in effect on December 31, 2001. We will also continue until no later
than April 1, 2002 to make transitional pass-through payments for drugs
and devices without applying the uniform reduction announced on
November 30, 2001.
Once our review has been completed and the rates corrected, we will
publish a final rule with revised rates and a revised calculation of
the uniform reduction in transitional pass-through payments. We will
announce the effective date of these changes in that rule.
II. List of OPPS Provisions That Are Not Delayed
This document does not delay the following provisions:
Medicare, Medicaid, and SCHIP Benefits Improvement and
Protection Act of 2000 coinsurance limit.
Limitation of coinsurance amount to inpatient hospital
deductible amount.
Changes in services covered within the scope of OPPS.
Categories of hospitals subject to, and excluded from, the
OPPS.
Criteria for new technology APCs.
Provider-based issues.
Change to the definition of ``single-use devices'' for
transitional pass-through payments.
III. Waiver of Notice of Proposed Rulemaking and the 30-Day Delay
in the Effective Date
We ordinarily publish a notice of proposed rulemaking in the
Federal Register and invite public comment on the proposed rule. The
notice of proposed rulemaking includes a reference to the legal
authority under which the rule is proposed, and the terms and
substances of the proposed rule or a description of the subjects and
issues involved. This procedure can be waived, however, if an agency
finds good cause that a notice-and-comment
[[Page 67495]]
procedure is impracticable, unnecessary, or contrary to the public
interest and incorporates a statement of the finding and its reasons in
the rule issued.
We normally provide a delay of 30 days in the effective date of a
final rule. However, if adherence to this procedure would be
impracticable, unnecessary, or contrary to the public interest, we may
waive the delay in the effective date. We find that a 30-day delay in
the effective date of this regulation would be both impracticable and
contrary to the public interest. In addition, although this is an
ongoing final rule proceeding, we nevertheless have good cause to waive
notice and comment. As we have discussed above, the rates that are
scheduled to go into effect on January 1, 2002 reflect inadvertent
technical errors that have major consequences. We, therefore, do not
believe it is appropriate to implement the new rates on January 1,
2002. To proceed with making payments on the basis of significantly
incorrect rates would be imprudent and contrary to the public interest.
These errors were discovered within 30 days of the January 1, 2002
effective date. Therefore, there is an urgent need to proceed with a
delay in the effective date of the 2002 rates, and there is not
sufficient time to provide notice of proposed rulemaking and a 30-day
notice of the delay.
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare--Hospital Insurance; and Program No. 93.774, Medicare--
Supplementary Medical Insurance Program)
Dated: December 18, 2001.
Thomas A. Scully,
Administrator, Centers for Medicare & Medicaid Services.
Approved: December 21, 2001.
Tommy G. Thompson,
Secretary.
[FR Doc. 01-32091 Filed 12-27-01; 8:55 am]
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