[Federal Register Volume 74, Number 15 (Monday, January 26, 2009)]
[Rules and Regulations]
[Pages 4343-4344]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-1519]
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Rules and Regulations
Federal Register
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Federal Register / Vol. 74, No. 15 / Monday, January 26, 2009 / Rules
and Regulations
[[Page 4343]]
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 410, 416, and 419
[CMS-1404-CN]
RIN 0938-AP17; RIN 0938-AL80; RIN 0938-AH17
Medicare Program; Changes to the Hospital Outpatient Prospective
Payment System and CY 2009 Payment Rates; Changes to the Ambulatory
Surgical Center Payment System and CY 2009 Payment Rates; Hospital
Conditions of Participation: Requirements for Approval and Re-Approval
of Transplant Centers To Perform Organ Transplants--Clarification of
Provider and Supplier Termination Policy Medicare and Medicaid
Programs: Changes to the Ambulatory Surgical Center Conditions for
Coverage
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Correction of final rule with comment period.
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SUMMARY: This document corrects technical errors that appeared in the
final rule with comment period published in the Federal Register on
November 18, 2008, entitled ``Medicare Program; Changes to the Hospital
Outpatient Prospective Payment System and CY 2009 Payment Rates;
Changes to the Ambulatory Surgical Center Payment System and CY 2009
Payment Rates; Hospital Conditions of Participation: Requirements for
Approval and Re-Approval of Transplant Centers To Perform Organ
Transplants--Clarification of Provider and Supplier Termination Policy
Medicare and Medicaid Programs: Changes to the Ambulatory Surgical
Center Conditions for Coverage'' (hereinafter referred to as the CY
2009 OPPS/ASC final rule with comment period).
DATES: Effective Date: this document is effective on January 26, 2009.
Applicability Date: The corrections in this document are applicable
on and after January 1, 2009.
FOR FURTHER INFORMATION CONTACT: Alberta Dwivedi, (410) 786-0378.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. E8-26212 of November 18, 2008 (73 FR 68502), there were
a few technical errors that are identified in the ``Summary of Errors''
section and corrected in the ``Correction of Errors'' section below.
II. Summary of Errors
We incorrectly determined the CY 2009 status indicator for new CY
2009 Healthcare Common Procedure Coding System (HCPCS) code J3300
(Injection, triamcinolone acetonide, preservative free, 1 mg) and, as a
result, incorrectly assigned HCPCS code J3300 status indicator ``N.''
Status indicator ``N'' indicates that items and services are packaged
into ambulatory payment classification (APC) rates. Payment for those
items and services assigned status indicator ``N'' is packaged into
payment for other services, including, for example, outliers, and,
therefore, there is no separate APC payment. The CY 2009 OPPS/ASC final
rule with comment period included several Addenda. The erroneous
assignment of status indicator ``N'' to HCPCS code J3300 appears in
Addendum B on page 69228. On that page, we are changing the status
indicator of HCPCS code J3300 from ``N'' to ``K'' (Nonpass-Through
Drugs and Biologicals; Paid under OPPS; separate APC payment) to
correctly reflect its separately payable status for CY 2009. As a
result of our error in determining the status indicator of HCPCS code
J3300, and the corresponding incorrect indication of status indicator
``N'' in Addendum B, we need to make two additional conforming changes.
Because we incorrectly packaged HCPCS code J3300 in the CY 2009
OPPS/ASC final rule with comment period, we provided no APC assignment
for the HCPCS code in that rule. With the correct assignment of status
indicator ``K'' to HCPCS code J3300, an APC must be established for
payment, because each separately payable drug or biological is assigned
to its own unique APC under the OPPS. Therefore, in Addendum A, on page
68831, we are adding APC 1253 (Triamcinolone A inj PRS-free) with
status indicator ``K.'' Also, in Addendum BB, on page 69301, a similar
change to that made in Addendum B needs to be made to correspond to the
Ambulatory Surgical Center (ASC) payment system. Accordingly, we are
changing the ASC payment indicator for HCPCS code J3300 from ``N1'' to
``K2'' (Drugs and biologicals paid separately when provided integral to
a surgical procedure on ASC list; payment based on OPPS rate) to
correctly reflect separate payment of HCPCS code J3300 under the ASC
payment system.
III. Correction of Errors
In FR Doc. E8-26212 of November 18, 2008 (73 FR 68502), make the
following corrections:
Addendum A.--Final OPPS APCs for CY 2009
1. On page 68831, in column 1, insert between APC 1251 and APC
1280, lines 24 and 25, the final OPPS CY 2009 entry for APC 1253 to
read as follows:
----------------------------------------------------------------------------------------------------------------
National Minimum
APC Group title SI Relative Payment unadjusted unadjusted
weight rate copayment copayment
----------------------------------------------------------------------------------------------------------------
1253........................... Triamcinolone A inj K .......... $3.18 .......... $0.64
PRS-free.
----------------------------------------------------------------------------------------------------------------
[[Page 4344]]
Addendum B.--Final OPPS Payment by HCPCS Code for CY 2009
2. On page 69228, in line 31, for HCPCS Code J3300--
A. In column 4, the status indicator ``N'' is corrected to read
``K.''
B. In column 5, the APC is corrected to read ``1253.''
C. In column 7, the payment rate is corrected to read ``$3.18.''
D. In column 9, the minimum unadjusted copayment is corrected to
read ``$0.64.''
The HCPCS Code for J3300 should read as follows:
--------------------------------------------------------------------------------------------------------------------------------------------------------
National Minimum
HCPCS Code Short descriptor CI SI APC Relative Payment unadjusted unadjusted
weight rate copayment copayment
--------------------------------------------------------------------------------------------------------------------------------------------------------
J3300........................... Triamcinolone A inj PRS-free...... NI K 1253 .......... $3.18 .......... $0.64
--------------------------------------------------------------------------------------------------------------------------------------------------------
Addendum BB.--Final ASC Covered Ancillary Services Integral to Covered
Surgical Procedures for CY 2009 (Including Ancillary Services for Which
Payment Is Packaged)
3. On page 69301, in line 37, for HCPCS Code J3300--
A. In column 4, the payment indicator ``N1'' is corrected to read
``K2.''
B. In column 6, the CY 2009 second year transition payment is
corrected to read ``$3.18.''
IV. Waiver of Proposed Rulemaking and Delay in Effective Date
We ordinarily publish a notice of proposed rulemaking in the
Federal Register to provide a period for public comment before the
provisions of a notice such as this take effect, in accordance with
section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C.
553(b)). We also ordinarily provide a 30-day delay in the effective
date of the provisions of a notice in accordance with section 553(d) of
the APA (5 U.S.C. 553(d)). However, we can waive both the notice and
comment procedure and the 30-day delay in effective date if the
Secretary finds, for good cause, that it is impracticable, unnecessary
or contrary to the public interest to follow the notice and comment
procedure or to comply with the 30-day delay in the effective date, and
incorporates a statement of the finding and the reasons in the notice.
The policies and payment methodologies finalized in the CY 2009
OPPS/ASC final rule with comment period have previously been subjected
to notice and comment procedures. This correction notice merely
provides technical corrections to the CY 2009 OPPS/ASC final rule with
comment period that was promulgated through notice and comment
rulemaking, and does not make substantive changes to the policies or
payment methodologies that were finalized in the final rule with
comment period. In order to conform the document to the final policies
of the CY 2009 OPPS/ASC final rule with comment period, this notice
makes changes to revise inaccurate tabular information. Therefore, we
find it unnecessary to undertake further notice and comment procedures
with respect to this correction notice. In addition, we believe it is
important for the public to have the correct information as soon as
possible and find no reason to delay the dissemination of it. For the
reasons stated above, we find that both notice and comment and the 30-
day delay in effective date for this correction notice are unnecessary.
Therefore, we find there is good cause to waive notice and comment
procedures and the 30-day delay in effective date for this correction
notice.
(Catalog of Federal Domestic Assistance Program No. 93.774,
Medicare--Supplementary Medical Insurance Program)
Dated: January 16, 2009.
Ann Agnew,
Executive Secretary to the Department.
[FR Doc. E9-1519 Filed 1-23-09; 8:45 am]
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