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Lengthy hospital stays are no longer the only option for some stem what do i need to buy viagra cell transplant patients. The first what do i need to buy viagra UC Davis Comprehensive Cancer Center patient to receive a transplant on an outpatient basis at is back home and in remission. UC Davis nurses “crowned” Dara Karl a day after she became the first UC Davis patient to receive an outpatient stem cell transplant.“I love the fact that I could be part of such a success,” said Benicia resident Dara Karl, the first multiple myeloma patient to receive a stem cell transplant at UC Davis Health without being hospitalized during the procedure.Many blood cancers are resistant to standard doses of chemotherapy. Studies have shown that what do i need to buy viagra high doses of chemotherapy can eradicate many, if not all, cancer cells that are resistant to standard doses of chemotherapy.

However, high doses will also damage the bone marrow and stem cells that reside within it. Stem cell transplantation, sometimes referred to as a bone marrow transplant, is a procedure in which a patient receives their own archived stem cells to allow them to recover from the effects of high doses of what do i need to buy viagra chemotherapy.What patients are good candidates for an outpatient stem cell transplant?. They need to be receiving an autologous stem cell transplant and fit the following criteria:• Be in relatively good health.• Live within an hour drive of the UC Davis Medical Center or willing to stay at a nearby hotel.• Have a responsible relative or friend who can serve as a support system for the patient 24/7 for at least two weeks.• Agree to follow prevention guidelines (i.e., wear mask, and stick to a strict medication and diet regimen).• Refrain from allowing pets or young children in the home during the treatment process.After the stem cells are infused into a patient’s bloodstream, they travel to the bone marrow and begin the process of forming new, healthy blood cells, including white blood cells, red blood cells and platelets.A month following her stem cell transplant, Dara was told by her oncologist that her cancer was in deep remission. In fact, there was no sign of the cancer at all.Karl said she doesn’t feel like a pioneer and she says she simply did, “what my doctors told me to do.” what do i need to buy viagra The widow and mother of two grown daughters—one a professor in Oklahoma and the other severely disabled with cerebral palsy at home—Karl didn’t want to endure a typical three- week stay in a hospital for the transplant procedure.

Her sister, Deb Deans, was by her side through it all as the two relaxed, following the procedure, in the comforts of the Marriott Hotel on the UC Davis Health campus. €œDelicious meals were brought to us by hospital staff and we were able to have some of our own diet-compliant snacks thanks to the room having a kitchenette,” said what do i need to buy viagra Karl. “It certainly was a lot better than being in a hospital room, with the sounds of medical equipment and nurses coming in, day and night.”Karl did have minor complications not related to the outpatient procedure and spent a few days in the hospital toward the end of her two-week recovery, but said she was pleased she was able to spend her initial recovery time in the hotel.A stem cell transplant may be:• Autologous (using a patient’s own stem cells that were collected and saved before treatment)• Allogeneic (using stem cells from a related or unrelated donor)• Syngeneic (using stem cells donated by an identical twin)• Cord blood (using umbilical cord blood donated after a baby is born)UC Davis oncologist Joseph Tuscano performed the two-hour transplant in late April. He said most outpatient stem cell what do i need to buy viagra transplant patients will be able to recover at home as long as they live within an hour of the cancer center.

If not, hotel accommodations on campus are available.“Outpatient stem cell transplants offer the full benefits of the standard inpatient version of this lifesaving procedure,” said Tuscano. €œBut we think there will be a decrease in recovery time and an increase in the mental what do i need to buy viagra wellness of patients who can become stressed by long hospitalizations and separation from family.”Offering outpatient stem cell transplants is even more important during times such as the erectile dysfunction treatment viagra, when visitors to the hospital are limited.“We think being with loved ones is an important part of the recovery process,” said Tuscano. €œIt also lowers health care costs and allows the patient to get back to enjoying life, which is what it is all about.” UC Davis Comprehensive Cancer CenterUC Davis Comprehensive Cancer Center is the only National Cancer Institute-designated center serving the Central Valley and inland Northern California, a region of more than 6 million people. Its specialists provide compassionate, comprehensive care for more than 15,000 adults and children every year and access to more than 150 active clinical what do i need to buy viagra trials at any given time.

Its innovative research program engages more than 225 scientists at UC Davis who work collaboratively to advance discovery of new tools to diagnose and treat cancer. Patients have access to leading-edge care, what do i need to buy viagra including immunotherapy and other targeted treatments. Its Office of Community Outreach and Engagement addresses disparities in cancer outcomes across diverse populations, and the cancer center provides comprehensive education and workforce development programs for the next generation of clinicians and scientists. For more information, visit cancer.ucdavis.edu.The Neonatal Intensive Care Unit (NICU) at UC Davis Children’s Hospital what do i need to buy viagra is now the 12th NICU in the U.S.

To receive a gold-level Beacon Award for Excellence from the American Association of Critical-Care Nurses (AACN). It is the only hospital in Northern what do i need to buy viagra California to receive this honor. The UC Davis NICU received a gold-level Beacon Award for Excellence. The Beacon Award for Excellence — a significant milestone on the path to exceptional patient care and healthy work environments — recognizes caregivers who what do i need to buy viagra successfully improve patient outcomes and align practices with AACN’s six Healthy Work Environment Standards.

These standards are skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition and what do i need to buy viagra authentic leadership. “We are so proud to receive this award,” said Sheryl Ruth, nurse manager of the UC Davis NICU. €œThis award recognizes the quality of care and what do i need to buy viagra commitment to constant improvement, while providing an environment that empowers nurses.”AACN President Beth Wathen applauds the commitment of the caregivers at the UC Davis NICU for working together to meet and exceed the high standards set forth by the Beacon Award for Excellence.“The Beacon Award for Excellence is a testament to a team’s commitment to providing safe, patient-centered and evidence-based care to patients and families. Creating healthy and supportive work environments empowers nurses and other team members to make their optimal contribution,” Wathen explained.

€œAchieving this award what do i need to buy viagra is an honor that brings such joy to those who have worked so hard to achieve excellence in patient care and positive patient outcomes.”The gold-level Beacon Award for Excellence signifies an effective and systematic approach to policies, procedures and processes that include engagement of staff and key stakeholders. Fact-based evaluation strategies for continuous process improvement. And performance measures that meet or exceed relevant what do i need to buy viagra benchmarks. UC Davis Children’s Hospital’s NICU earned a gold award by meeting the following evidence-based Beacon Award for Excellence criteria:Leadership Structures and SystemsAppropriate Staffing and Staff EngagementEffective Communication, Knowledge Management, and Learning and DevelopmentEvidence-Based Practice and ProcessesOutcome MeasurementAbout the Beacon Award for Excellence.

Established in 2003, the what do i need to buy viagra Beacon Award for Excellence offers a road map to help guide exceptional care through improved outcomes and greater overall patient satisfaction. U.S. And Canadian units where patients receive their what do i need to buy viagra principal nursing care after hospital admission qualify for this excellence award. Units that receive the Beacon Award for Excellence meet criteria in six categories.

Leadership structures and what do i need to buy viagra systems. Appropriate staffing and staff engagement. Effective communication, what do i need to buy viagra knowledge management, and learning and development. Evidence-based practice and processes.

And outcome measurement what do i need to buy viagra. To learn more, visit www.aacn.org/beacon or call 800-899-2226.About the American Association of Critical-Care Nurses. Founded in 1969 and based in Aliso Viejo, Calif., the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the what do i need to buy viagra world. AACN represents the interests of more than half a million acute and critical care nurses and includes more than 200 chapters in the United States.

The organization’s vision is to create a health care system driven by the needs of patients and their families in which acute and critical care what do i need to buy viagra nurses make their optimal contribution. To learn more about AACN, visit www.aacn.org, connect with the organization on Facebook at www.facebook.com/aacnface or follow AACN on Twitter at www.twitter.com/aacnme..

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Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia, Children´s Hospital Westmead, Sydney, NSW, can u buy viagra over the counter Australia 3. University of Virginia, Division of Infectious Diseases and International Health, Charlottesville, VA, USAPublication date:01 January 2021More about this publication?. The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information can u buy viagra over the counter on lung health world-wide.

To share scientific research of immediate concern as rapidly as possible, The Union is fast-tracking the publication of certain articles from the IJTLD and publishing them on The Union website, prior to their publication in the Journal. Read fast-track articles.Certain IJTLD articles are also selected for translation into French, Spanish, Chinese or Russian.

No Supplementary Data.No Article MediaNo what do i need to buy viagra https://www.gastern.at/event/altstoffsammelzentrum-40/ MetricsDocument Type. EditorialAffiliations:Division of Respiratory Medicine, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, ChinaPublication date:01 January 2021More about this publication?. The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD what do i need to buy viagra is dedicated to the continuing education of physicians and health personnel and the dissemination of information on lung health world-wide. To share scientific research of immediate concern as rapidly as possible, The Union is fast-tracking the publication of certain articles from the IJTLD and publishing them on The Union website, prior to their publication in the Journal.

Read fast-track articles.Certain IJTLD articles are also selected for translation into French, Spanish, Chinese or Russian. These are available on the Union website.Editorial BoardInformation for AuthorsSubscribe to this TitleInternational Journal of Tuberculosis and Lung DiseasePublic Health what do i need to buy viagra ActionIngenta Connect is not responsible for the content or availability of external websitesDownload Article. Download (PDF 53.5 kb) No AbstractNo Reference information available - sign in for access. No Supplementary Data.No Article MediaNo MetricsDocument Type. EditorialAffiliations:1.

University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, NSW, Australia, Westmead Hospital, Sydney, NSW, Australia, Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia 2. Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia, Children´s Hospital Westmead, Sydney, NSW, Australia 3. University of Virginia, Division of Infectious Diseases and International Health, Charlottesville, VA, USAPublication date:01 January 2021More about this publication?. The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on lung health world-wide.

To share scientific research of immediate concern as rapidly as possible, The Union is fast-tracking the publication of certain articles from the IJTLD and publishing them on The Union website, prior to their publication in the Journal. Read fast-track articles.Certain IJTLD articles are also selected for translation into French, Spanish, Chinese or Russian. These are available on the Union website.Editorial BoardInformation for AuthorsSubscribe to this TitleInternational Journal of Tuberculosis and Lung DiseasePublic Health ActionIngenta Connect is not responsible for the content or availability of external websites.

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Shutterstock The California Alcohol Policy Alliance (CAPA), in conjunction with the Alcohol Justice, held its fifth annual summit virtually over Kamagra online australia three days earlier this month.CAPA pursues advocacy and 100mg viagra for sale policy change regarding alcohol-related health and safety issues. Each day of the summit had a theme. Equity, alcohol 100mg viagra for sale injustice.

erectile dysfunction treatment and alcohol. And social justice-informed 100mg viagra for sale policy. Nearly 300 public health experts and advocates attended.“Rising to overcome the challenges of erectile dysfunction treatment, this year’s summit was an exciting success,” Richard Zaldivar, Alcohol Justice board chairman, said.

€œCAPA has 100mg viagra for sale developed an intersectional approach to alcohol policy that has earned the respect of public health and safety-minded activists and lawmakers throughout California. We look forward to supporting CAPA’s continuing participation in crafting public policy that places community health and safety over alcohol industry profits.”Dr. Barbara Ferrer, Los Angeles County 100mg viagra for sale Department of Public Health director, and California State Assemblymember Tom Lackey acknowledged CAPA attendees in video messages.“Even though erectile dysfunction treatment made it impossible to come together physically with activists from throughout the state, we were still able to celebrate past CAPA victories and plan new strategies,” Gilbert Mora, CAPA co-chairman, said.

€œThe virtual turnout produced unexpected moments of deep insight and inspiration. CAPA is ready to move forward with confidence and strength to 100mg viagra for sale demand social justice in public health in California.”Shutterstock U.S. Sens.

Elizabeth Warren (D-MA) and Tammy Baldwin (D-WI) want the General Accounting Office (GAO) to investigate mandatory work requirements at drug and alcohol treatment facilities that 100mg viagra for sale receive federal funding. Following a recent report by the Center for Investigative Journalism that found that individuals at some drug and alcohol rehab facilities are required to work without pay as part of their treatment program, Warner, a member of the Health, Education, Labor, and Pensions (HELP) Committee, and Baldwin, Ranking Member of the Subcommittee on Employment and Workplace Safety, are asking the GAO to look into whether or not the practices violate federal law. €œRequiring individuals to work without compensation is a violation of the Fair Labor Standards Act (FLSA), which 100mg viagra for sale establishes standards for labor protections including minimum wage and overtime pay,” the senators wrote.In the investigation, reporters found rehab facilities would contract those in the programs out as labor for private companies and corporations.

While those in the programs receive no compensation for their time, the rehab facilities are paid for the labor they provide. The practice creates a “huge, unpaid shadow 100mg viagra for sale workforce,” according to the investigation.“Individuals struggling with substance use disorder who attend rehabilitation programs should never be subjected to predatory conditions that threaten their recovery and violate their rights under the law,” the report said. The senators also wrote that there seems to be little to no evidence that these work programs successfully treat drug and alcohol issues.

According to Substance Abuse and Mental Health Services Administration (SAMHSA) guidance, the senators wrote, “few studies have addressed the effectiveness of vocational services in substance abuse treatment settings,” adding that programs investigated through those existing studies “did not demonstrate much long-term effect and did not decrease substance use.”Shutterstock Arkansas Attorney General Leslie Rutledge announced Friday 100mg viagra for sale that the Ninth Annual Arkansas Prescription Drug Abuse Prevention Summit would be held virtually on Dec. 8, 2020. The summit, which will be held following CDC guidelines surrounding the erectile dysfunction treatment viagra, will offer free training and educational opportunities for law enforcement officers, medical professionals, treatment specialists, pharmacists, 100mg viagra for sale educators, and family members.

€œNow more than ever, Arkansans need education and training to support those with opioid addiction, and this year’s event provides the opportunity to reach even more Arkansans where they are,” said Attorney General Rutledge. €œI am so proud of the partnership that has been fostered from our Summit and am confident that this year’s event will have an even further reach and build on those partnerships to save lives and help end the opioid crisis.”The summit will provide plenary sessions and breakouts and an attendee “lounge” where participants can meet and network with other attendees. All registered participants will have access to the 100mg viagra for sale summit’s online content for three months after the event.

Attendees will hear from Rutledge as well as Arkansas Gov. Asa Hutchinson, 100mg viagra for sale Sen. Tom Cotton (R-AR), and John Kirtley, executive director of the Arkansas Board of Pharmacy, this year’s recipient of the National Lester Hosto Distinguished Service Award from the National Association of Boards of Pharmacy.Breakout sessions will include topics like the neurobiology of addiction and recovery, opioid trends, the truth about prescription drugs, and recovery resources.Shutterstock A recent virtual roundtable, hosted by White House Office of National Drug Control Policy Director Jim Carroll and U.S.

Sen. Pat Toomey (R-PA), discussed efforts to combat the opioid epidemic.Discussions included federal and local efforts to reduce opioid misuse. Earlier this year, Toomey introduced two bills addressing the crisis.

The Blocking Deadly Fentanyl Imports Act would penalize foreign countries that fail to limit the flow of illicit fentanyl into the United States. The IMPROVE Addiction Care Act would notify Medicare Part D plan sponsors of individuals with a history of opioid-related overdose.“… the topic about which I’ve had the most meetings and discussions since I joined the Senate has been the opioid epidemic and the drug addiction that is related to it,” Toomey said. €œThis is a scourge that continues to impact our entire commonwealth.

It does not discriminate based on age, race, social standing, or geography, and it’s been devastating. I think it’s also true that there’s been some progress in recent years.”Panelists included Dr. Julie Donohue from the University of Pittsburgh Graduate School of Public Health.

Dr. Jeanmarie Perrone, Penn Medicine Center for Addiction Medicine and Policy founding director and Hospital of the University of Pennsylvania professor of emergency medicine. And David Kennedy, Pennsylvania State Troopers Association president.Shutterstock Approximately one in five adults in the United States, 50.6 million people, used tobacco products in 2019, according to a Centers for Disease Control and Prevention (CDC) report.The CDC analyzed data from the 2019 National Health Interview Survey, a measure of cigarette, cigar, pipe, e-cigarette, and smokeless tobacco use.

Among tobacco users, 80.5 percent used combustible products, with cigarettes as the most commonly used product. Cigarettes were followed by e-cigarettes, cigars, smokeless tobacco, and pipes.A total of 56 percent of 18 to 24 yeas olds never smoked cigarettes but did use e-cigarettes.Among the survey participants, 18.6 percent used two or more tobacco products. €œFindings from this study show that disparities in tobacco product use continue to persist,” Dr.

Karen Hacker, CDC National Center for Chronic Disease Prevention and Health Promotion director, said. €œThere is still much more that needs to be done to protect everyone from the harmful effects of tobacco use.”Tobacco use was highest among people 25 years old or older with a General Educational Development certificate, those suffering from a generalized anxiety disorder, those who are uninsured or on Medicaid, those earning less than $35,000 annually, those living in the Midwest or the South, and those with disabilities..

Shutterstock The California Alcohol Policy Alliance (CAPA), in conjunction with the Alcohol Justice, held its fifth annual summit what do i need to buy viagra Kamagra online australia virtually over three days earlier this month.CAPA pursues advocacy and policy change regarding alcohol-related health and safety issues. Each day of the summit had a theme. Equity, alcohol injustice what do i need to buy viagra.

erectile dysfunction treatment and alcohol. And social what do i need to buy viagra justice-informed policy. Nearly 300 public health experts and advocates attended.“Rising to overcome the challenges of erectile dysfunction treatment, this year’s summit was an exciting success,” Richard Zaldivar, Alcohol Justice board chairman, said.

€œCAPA has developed an intersectional approach to alcohol policy that has earned the respect of public health and safety-minded activists and lawmakers what do i need to buy viagra throughout California. We look forward to supporting CAPA’s continuing participation in crafting public policy that places community health and safety over alcohol industry profits.”Dr. Barbara Ferrer, Los Angeles County what do i need to buy viagra Department of Public Health director, and California State Assemblymember Tom Lackey acknowledged CAPA attendees in video messages.“Even though erectile dysfunction treatment made it impossible to come together physically with activists from throughout the state, we were still able to celebrate past CAPA victories and plan new strategies,” Gilbert Mora, CAPA co-chairman, said.

€œThe virtual turnout produced unexpected moments of deep insight and inspiration. CAPA is ready to move forward with confidence and strength to what do i need to buy viagra demand social justice in public health in California.”Shutterstock U.S. Sens.

Elizabeth Warren (D-MA) and Tammy Baldwin (D-WI) want the General Accounting Office (GAO) to investigate mandatory work requirements at drug and alcohol treatment facilities that receive federal what do i need to buy viagra funding. Following a recent report by the Center for Investigative Journalism that found that individuals at some drug and alcohol rehab facilities are required to work without pay as part of their treatment program, Warner, a member of the Health, Education, Labor, and Pensions (HELP) Committee, and Baldwin, Ranking Member of the Subcommittee on Employment and Workplace Safety, are asking the GAO to look into whether or not the practices violate federal law. €œRequiring individuals to work without compensation is a violation of the Fair Labor Standards Act (FLSA), which establishes standards for labor protections what do i need to buy viagra including minimum wage and overtime pay,” the senators wrote.In the investigation, reporters found rehab facilities would contract those in the programs out as labor for private companies and corporations.

While those in the programs receive no compensation for their time, the rehab facilities are paid for the labor they provide. The practice creates a “huge, unpaid shadow workforce,” according to the what do i need to buy viagra investigation.“Individuals struggling with substance use disorder who attend rehabilitation programs should never be subjected to predatory conditions that threaten their recovery and violate their rights under the law,” the report said. The senators also wrote that there seems to be little to no evidence that these work programs successfully treat drug and alcohol issues.

According to Substance Abuse and Mental Health Services Administration (SAMHSA) guidance, the senators wrote, “few studies have what do i need to buy viagra addressed the effectiveness of vocational services in substance abuse treatment settings,” adding that programs investigated through those existing studies “did not demonstrate much long-term effect and did not decrease substance use.”Shutterstock Arkansas Attorney General Leslie Rutledge announced Friday that the Ninth Annual Arkansas Prescription Drug Abuse Prevention Summit would be held virtually on Dec. 8, 2020. The summit, which will be held following CDC guidelines surrounding the erectile dysfunction treatment viagra, will offer free training and educational opportunities for law enforcement officers, medical what do i need to buy viagra professionals, treatment specialists, pharmacists, educators, and family members.

€œNow more than ever, Arkansans need education and training to support those with opioid addiction, and this year’s event provides the opportunity to reach even more Arkansans where they are,” said Attorney General Rutledge. €œI am so proud of the partnership that has been fostered from our Summit and am confident that this year’s event will have an even further reach and build on those partnerships to save lives and help end the opioid crisis.”The summit will provide plenary sessions and breakouts and an attendee “lounge” where participants can meet and network with other attendees. All registered participants will have access to the summit’s online content for three months what do i need to buy viagra after the event.

Attendees will hear from Rutledge as well as Arkansas Gov. Asa Hutchinson, what do i need to buy viagra Sen. Tom Cotton (R-AR), and John Kirtley, executive director of the Arkansas Board of Pharmacy, this year’s recipient of the National Lester Hosto Distinguished Service Award from the National Association of Boards of Pharmacy.Breakout sessions will include topics like the neurobiology of addiction and recovery, opioid trends, the truth about prescription drugs, and recovery resources.Shutterstock A recent virtual roundtable, hosted by White House Office of National Drug Control Policy Director Jim Carroll and U.S.

Sen. Pat Toomey (R-PA), discussed efforts to combat the opioid epidemic.Discussions included federal and local efforts to reduce opioid misuse. Earlier this year, Toomey introduced two bills addressing the crisis.

The Blocking Deadly Fentanyl Imports Act would penalize foreign countries that fail to limit the flow of illicit fentanyl into the United States. The IMPROVE Addiction Care Act would notify Medicare Part D plan sponsors of individuals with a history of opioid-related overdose.“… the topic about which I’ve had the most meetings and discussions since I joined the Senate has been the opioid epidemic and the drug addiction that is related to it,” Toomey said. €œThis is a scourge that continues to impact our entire commonwealth.

It does not discriminate based on age, race, social standing, or geography, and it’s been devastating. I think it’s also true that there’s been some progress in recent years.”Panelists included Dr. Julie Donohue from the University of Pittsburgh Graduate School of Public Health.

Dr. Jeanmarie Perrone, Penn Medicine Center for Addiction Medicine and Policy founding director and Hospital of the University of Pennsylvania professor of emergency medicine. And David Kennedy, Pennsylvania State Troopers Association president.Shutterstock Approximately one in five adults in the United States, 50.6 million people, used tobacco products in 2019, according to a Centers for Disease Control and Prevention (CDC) report.The CDC analyzed data from the 2019 National Health Interview Survey, a measure of cigarette, cigar, pipe, e-cigarette, and smokeless tobacco use.

Among tobacco users, 80.5 percent used combustible products, with cigarettes as the most commonly used product. Cigarettes were followed by e-cigarettes, cigars, smokeless tobacco, and pipes.A total of 56 percent of 18 to 24 yeas olds never smoked cigarettes but did use e-cigarettes.Among the survey participants, 18.6 percent used two or more tobacco products. €œFindings from this study show that disparities in tobacco product use continue to persist,” Dr.

Karen Hacker, CDC National Center for Chronic Disease Prevention and Health Promotion director, said. €œThere is still much more that needs to be done to protect everyone from the harmful effects of tobacco use.”Tobacco use was highest among people 25 years old or older with a General Educational Development certificate, those suffering from a generalized anxiety disorder, those who are uninsured or on Medicaid, those earning less than $35,000 annually, those living in the Midwest or the South, and those with disabilities..

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Start Preamble Office of the Assistant Secretary for Health, Office of the viagra history Secretary, Department of Full Article Health and Human Services. Notice of meeting. As required by the Federal Advisory Committee Act, viagra history the U.S.

Department of Health and Human Services (HHS) is hereby giving notice that the erectile dysfunction treatment Health Equity Task Force (Task Force) will hold a virtual meeting on July 30, 2021. The purpose of this meeting is to consider interim recommendations addressing future viagra preparedness, mitigation, and resilience needed to ensure equitable response and recovery in communities of color and other viagra history underserved populations. This meeting is open to the public and will be live-streamed at www.hhs.gov/​live.

Information about the meeting will be posted on the HHS Office of Minority Health website. Www.minorityhealth.hhs.gov/​healthequitytaskforce/​ prior viagra history to the meeting. The Task Force meeting will be held on Friday, July 30, 2021, from 2 p.m.

To approximately 6 p.m viagra history. ET (date and time are tentative and subject to change). The confirmed time and agenda will be posted on the erectile dysfunction treatment Health Equity Task Force web page.

Www.minorityhealth.hhs.gov/​healthequitytaskforce/​ when viagra history this information becomes available. Start Further Info Samuel Wu, Designated Federal Officer for the Task Force. Office of Minority Health, viagra history Department of Health and Human Services, Tower Building, 1101 Wootton Parkway, Suite 100, Rockville, Start Printed Page 36563Maryland 20852.

erectile dysfunction treatment19HETF@hhs.gov. End Further Info End Preamble Start Supplemental Information Background. The erectile dysfunction treatment Health Equity Task Force (Task Force) was established by Executive Order 13995, dated January 21, 2021.

The Task Force is tasked with providing specific recommendations to the President, through the Coordinator of the erectile dysfunction treatment Response and Counselor to the President (erectile dysfunction treatment Response Coordinator), for mitigating the health inequities caused or exacerbated by the erectile dysfunction treatment viagra and for preventing such inequities in the future. The Task Force shall submit a final report to the erectile dysfunction treatment Response Coordinator addressing any ongoing health inequities faced by erectile dysfunction treatment survivors that may merit a public health response, describing the factors that contributed to disparities in erectile dysfunction treatment outcomes, and recommending actions to combat such disparities in future viagra responses. The meeting is open to the public and will be live-streamed at www.hhs.gov/​live.

No registration is required. A public comment session will be held during the meeting. Pre-registration is required to provide public comment during the meeting.

To pre-register, please send an email to erectile dysfunction treatment19HETF@hhs.gov and include your name, title, and organization by close of business on Friday, July 23, 2021. Comments will be limited to no more than three minutes per speaker and should be pertinent to the meeting discussion. Individuals are encouraged to provide a written statement of any public comment(s) for accurate minute-taking purposes.

If you decide you would like to provide public comment but do not pre-register, you may submit your written statement by emailing erectile dysfunction treatment19HETF@hhs.gov no later than close of business on Thursday, August 5, 2021. Individuals who plan to attend and need special assistance, such as sign language interpretation or other reasonable accommodations, should contact. erectile dysfunction treatment19HETF@hhs.gov and reference this meeting.

Requests for special accommodations should be made at least 10 business days prior to the meeting. Start Signature Dated. July 6, 2021.

Samuel Wu, Designated Federal Officer, erectile dysfunction treatment Health Equity Task Force. End Signature End Supplemental Information [FR Doc. 2021-14703 Filed 7-9-21.

8:45 am]BILLING CODE 4150-29-PAs the weather warmed up this year, erectile dysfunction case numbers plummeted, and life in the U.S. Started to feel almost normal. But in recent weeks, that progress has stalled.

The vaccination campaign has slowed, and the delta variant is spreading rapidly. And new s, which had started to plateau about a month ago, are going up slightly nationally. New, localized hot spots are emerging, especially in stretches of the South, the Midwest and the West.

And, according to an analysis NPR conducted with Johns Hopkins University, those surges are likely driven by pockets of dangerously low vaccination rates. "I think we should brace ourselves to see case increases, particularly in unvaccinated populations," says Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security. Loading...

Cases are rising in many states The number of people catching the viagra has risen in more than half of the states over the past two weeks. And 18 states have greater numbers of new s now compared with four weeks ago, including Arkansas, Florida, Iowa, Missouri and Oklahoma, where new daily cases have doubled. "It's an early trend," Nuzzo says.

"Unfortunately looking at what's happening in individual states, I do worry we will continue to see national numbers increase." The number of people getting hospitalized for erectile dysfunction treatment has also started rising again in nine states, according to Johns Hopkins. Arkansas, Florida, Hawaii, Iowa, Missouri, Nebraska, Texas, Wisconsin and Mississippi. "I expect that more states would join that list in a few weeks as they continue to see case increases," Nuzzo cautions.

Localized outbreaks at the county level To understand what's driving the small rise in cases at the state and national level, researchers are keeping an eye on county-level trends. Loading... A federal team including the Centers for Disease Control and Prevention does a daily ranking of counties' level of erectile dysfunction treatment risk and identifies those it considers hot spots.

These are places where erectile dysfunction treatment presents a "high burden" to the community, measured in part by a significant rise in cases as well as increases in case positivity rates. NPR and Johns Hopkins analyzed the current hot spots from the week of July 1 to July 7 to see how many of them have been in bad shape over a longer period. The analysis found that the vast majority of the CDC's hot spot counties from the last seven days have seen increases in new cases compared with one month ago — 104 out of the 136 counties.

This shows that for many of these hot spot counties, the rise in cases "isn't a blip," Nuzzo says. "That means that they're headed in the wrong direction" in those places. Many of the places with dramatic rises in cases are rural areas or small towns.

For example, Newton County, Mo., has seen a 182% increase in new s. Nacogdoches County, Texas, has seen a 632% increase. Ottawa County, Okla., has seen s soar 828%.

Nuzzo points out that for some of the rural hot spots, the increases may be small in terms of total numbers, but that these communities typically have fewer health care resources to treat even a slight rise in erectile dysfunction treatment cases. "The ability to save lives is dependent on there being enough resources to offer lifesaving medical care," she notes. "We could see people die from their that otherwise could have been saved." NPR analyzed counties included in a federal erectile dysfunction treatment hospitalization dataset and found that erectile dysfunction treatment hospital admissions rose modestly in one-quarter of these counties last week compared with two weeks ago.

Nearly half of the places where hospitalization increased were in Southern states, with Texas, North Carolina and Georgia leading. Another quarter of counties that increased were in the Midwest. Nuzzo says she's worried about a continued trend of "localized surges" around the country.

"Most of the [hot spot] counties are in states that are also reporting state-level increases, but not all are. In fact, we are seeing counties in states that we haven't really been worrying about — California and Washington state, for instance," Nuzzo says. Some of the hot spot counties are also in suburban and even urban areas.

For instance, Salt Lake City has had new s rise over the last month, as has Clark County, Nev., home to Las Vegas, and Contra Costa County, Calif., home to some San Francisco Bay Area suburbs. The link with low vaccination rates NPR's analysis with Johns Hopkins illustrates dramatically the impact of vaccination rates on risk for localized outbreaks. Most — 9 in 10 — of the CDC hot spot counties that have seen increasing cases over the last month had lower vaccination rates than the average U.S.

County. Loading... Nationally, 47.6% of the U.S.

Population was fully vaccinated as of July 7. Rates in many of the hot spot counties with sustained outbreaks were drastically lower. For instance, Ottawa County in Oklahoma has only vaccinated about 24% of its population.

Utah County, Utah, the second-most populous in the state, has about a 32% vaccination rate. The lowest rate in the list of hot spots was Newton County, Mo., at nearly 17%. While urban and suburban counties tend to have higher vaccination rates than rural ones overall, NPR's analysis found that hot spot counties, even in more urban areas, tend to have lagging vaccination rates.

And across all geographic types, hot spot counties had lower vaccination rates. For instance, among all U.S. Counties designated as "small urban" areas, the average vaccination rate was 41% nationally, whereas among the hot spots, it was 33%.

Loading... Researchers had long feared places with low vaccination rates would end up being at risk for outbreaks, says Dr. David Rubin, director of PolicyLab at Children's Hospital of Philadelphia, which has been tracking the viagra in the United States.

And now that pattern is proving true, he says. You can see this play out vividly in the different parts of Missouri, he notes. For example, St.

Louis County in the metro St. Louis area has a vaccination rate of 47% of the total population and is seeing a small increase in new s of 17% over the last 30 days. In Greene County, home to Springfield, Mo., the vaccination rate is more than 10 points lower and has seen a 275% increase in new cases.

"The emergence of the delta variant is going to mean for those areas with low rates of vaccination that they're very much at risk to see significant increases in transmission, with potentially even exponential growth," he says. Some regions may fall prey to a scattering of new outbreaks, while others may stay relatively unscathed, Rubin says. For instance, he points to New York and Massachusetts, which have high vaccination rates, and so far, few new s.

"It's like a wall has formed in the upper Northeast with regards to transmission," he says. But, as Nuzzo notes, localized flare-ups in unvaccinated areas could spread regionally. "One of the things that we keep forgetting about this viagra is that something that happens in one state is not isolated from something that will happen in another state," Nuzzo says.

"So as long as we keep seeing case increases in any part of the country, it remains a national crisis." A fall surge is predicted The troubling rises in cases and hospitalizations are stirring worries that the country may be on the cusp of yet another national surge that could continue into the fall. Ali Mokdad, a researcher with the University of Washington's Institute for Health Metrics and Evaluation, says the delta variant is a "game changer" for the group's forecasting models. "The delta variant has changed all our projections," he says.

"It's more likely to be transmitted, makes the treatments less effective. Previous s are not protective. We will see a rise in cases." And that rise is likely to occur in the summer instead of the fall, as the group had previously projected.

That's in line with forecasts from a group of modelers organized by the CDC. Deaths could start going up again too, by mid-August, Mokdad says. The Institute for Health Metrics and Evaluation projects that deaths could rise from their current rate of around 200 a day to up over 1,000 by fall.

And the burden of the viagra, Mokdad predicts, will not be evenly shared. "We're going to see a divide in the country," he says. Places that have high vaccination rates may still see small surges, he says, but "it will be much worse in these locations with low vaccination coverage." Things may worsen in the fall, in part because that's when more people will be heading indoors as a result of cold weather.

No one is predicting things will get anywhere close to as bad as last winter. But researchers emphasize that any increase in deaths is a travesty, given that erectile dysfunction treatment has essentially become a preventable disease. Mokdad notes that among recent erectile dysfunction treatment deaths, "the majority, 97[%] to 99% of the deaths, are among people who are not vaccinated." "It's so sad for me on a daily basis to look at the number of deaths in the United States, knowing that these mortalities could have been prevented.

No one — no one — should die from erectile dysfunction treatment19 while we have an effective treatment." Researchers are hoping these early hot spots will be a wake-up call to communities with lower vaccination rates. "They should be heeding the warning that's coming out of Missouri and Arkansas and recognizing that they need to boost their vaccination rates," says Rubin of PolicyLab at Children's Hospital of Philadelphia. Nuzzo agrees.

"There's a lot more that we can do to stop the spread of this viagra and to prevent people from being hospitalized or dying from it," she says. Alyson Hurt and Duy Nguyen of NPR and Emily Pond of the Johns Hopkins Center for Health Security contributed to this report. Methodology To categorize hot spots, NPR analyzed daily updates of all counties' rankings on the Area of Concern Continuum from July 1 to July 7, provided by the Centers for Disease Control and Prevention.

Sustained hot spots and hot spots were marked as such if they achieved that ranking at least once through the week. Among these hot spots, Johns Hopkins compared 30-day averages of new erectile dysfunction treatment cases to see where cases have seen sustained increases this month compared with the previous month. Vaccination data comes from county-level counts of fully vaccinated people as of July 7 provided by the CDC and the Texas Department of State Health Services.

NPR excluded Georgia, Vermont, Virginia and West Virginia, because fewer than 80% of their vaccination records included a person's county of residence. NPR used the National Center for Health Statistics 2013 Urban-Rural Classification Scheme to calculate average vaccination rates by county type, weighted by county population, both for all counties and for the hot spot counties. NPR calculated per-capita county hospitalization rates using seven-day counts of confirmed erectile dysfunction treatment hospital admissions for the weeks ending June 26 and July 3.

This data is provided in Community Profile Reports published by the White House erectile dysfunction treatment team..

Start Preamble Office of what do i need to buy viagra the Assistant Secretary for Health, Office of the Secretary, Department of Health and Human Services. Notice of meeting. As required by the Federal Advisory Committee Act, the U.S what do i need to buy viagra. Department of Health and Human Services (HHS) is hereby giving notice that the erectile dysfunction treatment Health Equity Task Force (Task Force) will hold a virtual meeting on July 30, 2021. The purpose of this meeting is to consider interim recommendations addressing future viagra preparedness, mitigation, and resilience needed to ensure equitable response and recovery in communities what do i need to buy viagra of color and other underserved populations.

This meeting is open to the public and will be live-streamed at www.hhs.gov/​live. Information about the meeting will be posted on the HHS Office of Minority Health website. Www.minorityhealth.hhs.gov/​healthequitytaskforce/​ prior what do i need to buy viagra to the meeting. The Task Force meeting will be held on Friday, July 30, 2021, from 2 p.m. To approximately what do i need to buy viagra 6 p.m.

ET (date and time are tentative and subject to change). The confirmed time and agenda will be posted on the erectile dysfunction treatment Health Equity Task Force web page. Www.minorityhealth.hhs.gov/​healthequitytaskforce/​ when what do i need to buy viagra this information becomes available. Start Further Info Samuel Wu, Designated Federal Officer for the Task Force. Office of Minority Health, Department of Health and Human Services, Tower Building, what do i need to buy viagra 1101 Wootton Parkway, Suite 100, Rockville, Start Printed Page 36563Maryland 20852.

Phone. 240-453-6173. Email. erectile dysfunction treatment19HETF@hhs.gov. End Further Info End Preamble Start Supplemental Information Background.

The erectile dysfunction treatment Health Equity Task Force (Task Force) was established by Executive Order 13995, dated January 21, 2021. The Task Force is tasked with providing specific recommendations to the President, through the Coordinator of the erectile dysfunction treatment Response and Counselor to the President (erectile dysfunction treatment Response Coordinator), for mitigating the health inequities caused or exacerbated by the erectile dysfunction treatment viagra and for preventing such inequities in the future. The Task Force shall submit a final report to the erectile dysfunction treatment Response Coordinator addressing any ongoing health inequities faced by erectile dysfunction treatment survivors that may merit a public health response, describing the factors that contributed to disparities in erectile dysfunction treatment outcomes, and recommending actions to combat such disparities in future viagra responses. The meeting is open to the public and will be live-streamed at www.hhs.gov/​live. No registration is required.

A public comment session will be held during the meeting. Pre-registration is required to provide public comment during the meeting. To pre-register, please send an email to erectile dysfunction treatment19HETF@hhs.gov and include your name, title, and organization by close of business on Friday, July 23, 2021. Comments will be limited to no more than three minutes per speaker and should be pertinent to the meeting discussion. Individuals are encouraged to provide a written statement of any public comment(s) for accurate minute-taking purposes.

If you decide you would like to provide public comment but do not pre-register, you may submit your written statement by emailing erectile dysfunction treatment19HETF@hhs.gov no later than close of business on Thursday, August 5, 2021. Individuals who plan to attend and need special assistance, such as sign language interpretation or other reasonable accommodations, should contact. erectile dysfunction treatment19HETF@hhs.gov and reference this meeting. Requests for special accommodations should be made at least 10 business days prior to the meeting. Start Signature Dated.

July 6, 2021. Samuel Wu, Designated Federal Officer, erectile dysfunction treatment Health Equity Task Force. End Signature End Supplemental Information [FR Doc. 2021-14703 Filed 7-9-21. 8:45 am]BILLING CODE 4150-29-PAs the weather warmed up this year, erectile dysfunction case numbers plummeted, and life in the U.S.

Started to feel almost normal. But in recent weeks, that progress has stalled. The vaccination campaign has slowed, and the delta variant is spreading rapidly. And new s, which had started to plateau about a month ago, are going up slightly nationally. New, localized hot spots are emerging, especially in stretches of the South, the Midwest and the West.

And, according to an analysis NPR conducted with Johns Hopkins University, those surges are likely driven by pockets of dangerously low vaccination rates. "I think we should brace ourselves to see case increases, particularly in unvaccinated populations," says Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security. Loading... Cases are rising in many states The number of people catching the viagra has risen in more than half of the states over the past two weeks. And 18 states have greater numbers of new s now compared with four weeks ago, including Arkansas, Florida, Iowa, Missouri and Oklahoma, where new daily cases have doubled.

"It's an early trend," Nuzzo says. "Unfortunately looking at what's happening in individual states, I do worry we will continue to see national numbers increase." The number of people getting hospitalized for erectile dysfunction treatment has also started rising again in nine states, according to Johns Hopkins. Arkansas, Florida, Hawaii, Iowa, Missouri, Nebraska, Texas, Wisconsin and Mississippi. "I expect that more states would join that list in a few weeks as they continue to see case increases," Nuzzo cautions. Localized outbreaks at the county level To understand what's driving the small rise in cases at the state and national level, researchers are keeping an eye on county-level trends.

Loading... A federal team including the Centers for Disease Control and Prevention does a daily ranking of counties' level of erectile dysfunction treatment risk and identifies those it considers hot spots. These are places where erectile dysfunction treatment presents a "high burden" to the community, measured in part by a significant rise in cases as well as increases in case positivity rates. NPR and Johns Hopkins analyzed the current hot spots from the week of July 1 to July 7 to see how many of them have been in bad shape over a longer period. The analysis found that the vast majority of the CDC's hot spot counties from the last seven days have seen increases in new cases compared with one month ago — 104 out of the 136 counties.

This shows that for many of these hot spot counties, the rise in cases "isn't a blip," Nuzzo says. "That means that they're headed in the wrong direction" in those places. Many of the places with dramatic rises in cases are rural areas or small towns. For example, Newton County, Mo., has seen a 182% increase in new s. Nacogdoches County, Texas, has seen a 632% increase.

Ottawa County, Okla., has seen s soar 828%. Nuzzo points out that for some of the rural hot spots, the increases may be small in terms of total numbers, but that these communities typically have fewer health care resources to treat even a slight rise in erectile dysfunction treatment cases. "The ability to save lives is dependent on there being enough resources to offer lifesaving medical care," she notes. "We could see people die from their that otherwise could have been saved." NPR analyzed counties included in a federal erectile dysfunction treatment hospitalization dataset and found that erectile dysfunction treatment hospital admissions rose modestly in one-quarter of these counties last week compared with two weeks ago. Nearly half of the places where hospitalization increased were in Southern states, with Texas, North Carolina and Georgia leading.

Another quarter of counties that increased were in the Midwest. Nuzzo says she's worried about a continued trend of "localized surges" around the country. "Most of the [hot spot] counties are in states that are also reporting state-level increases, but not all are. In fact, we are seeing counties in states that we haven't really been worrying about — California and Washington state, for instance," Nuzzo says. Some of the hot spot counties are also in suburban and even urban areas.

For instance, Salt Lake City has had new s rise over the last month, as has Clark County, Nev., home to Las Vegas, and Contra Costa County, Calif., home to some San Francisco Bay Area suburbs. The link with low vaccination rates NPR's analysis with Johns Hopkins illustrates dramatically the impact of vaccination rates on risk for localized outbreaks. Most — 9 in 10 — of the CDC hot spot counties that have seen increasing cases over the last month had lower vaccination rates than the average U.S. County. Loading...

Nationally, 47.6% of the U.S. Population was fully vaccinated as of July 7. Rates in many of the hot spot counties with sustained outbreaks were drastically lower. For instance, Ottawa County in Oklahoma has only vaccinated about 24% of its population. Utah County, Utah, the second-most populous in the state, has about a 32% vaccination rate.

The lowest rate in the list of hot spots was Newton County, Mo., at nearly 17%. While urban and suburban counties tend to have higher vaccination rates than rural ones overall, NPR's analysis found that hot spot counties, even in more urban areas, tend to have lagging vaccination rates. And across all geographic types, hot spot counties had lower vaccination rates. For instance, among all U.S. Counties designated as "small urban" areas, the average vaccination rate was 41% nationally, whereas among the hot spots, it was 33%.

Loading... Researchers had long feared places with low vaccination rates would end up being at risk for outbreaks, says Dr. David Rubin, director of PolicyLab at Children's Hospital of Philadelphia, which has been tracking the viagra in the United States. And now that pattern is proving true, he says. You can see this play out vividly in the different parts of Missouri, he notes.

For example, St. Louis County in the metro St. Louis area has a vaccination rate of 47% of the total population and is seeing a small increase in new s of 17% over the last 30 days. In Greene County, home to Springfield, Mo., the vaccination rate is more than 10 points lower and has seen a 275% increase in new cases. "The emergence of the delta variant is going to mean for those areas with low rates of vaccination that they're very much at risk to see significant increases in transmission, with potentially even exponential growth," he says.

Some regions may fall prey to a scattering of new outbreaks, while others may stay relatively unscathed, Rubin says. For instance, he points to New York and Massachusetts, which have high vaccination rates, and so far, few new s. "It's like a wall has formed in the upper Northeast with regards to transmission," he says. But, as Nuzzo notes, localized flare-ups in unvaccinated areas could spread regionally. "One of the things that we keep forgetting about this viagra is that something that happens in one state is not isolated from something that will happen in another state," Nuzzo says.

"So as long as we keep seeing case increases in any part of the country, it remains a national crisis." A fall surge is predicted The troubling rises in cases and hospitalizations are stirring worries that the country may be on the cusp of yet another national surge that could continue into the fall. Ali Mokdad, a researcher with the University of Washington's Institute for Health Metrics and Evaluation, says the delta variant is a "game changer" for the group's forecasting models. "The delta variant has changed all our projections," he says. "It's more likely to be transmitted, makes the treatments less effective. Previous s are not protective.

We will see a rise in cases." And that rise is likely to occur in the summer instead of the fall, as the group had previously projected. That's in line with forecasts from a group of modelers organized by the CDC. Deaths could start going up again too, by mid-August, Mokdad says. The Institute for Health Metrics and Evaluation projects that deaths could rise from their current rate of around 200 a day to up over 1,000 by fall. And the burden of the viagra, Mokdad predicts, will not be evenly shared.

"We're going to see a divide in the country," he says. Places that have high vaccination rates may still see small surges, he says, but "it will be much worse in these locations with low vaccination coverage." Things may worsen in the fall, in part because that's when more people will be heading indoors as a result of cold weather. No one is predicting things will get anywhere close to as bad as last winter. But researchers emphasize that any increase in deaths is a travesty, given that erectile dysfunction treatment has essentially become a preventable disease. Mokdad notes that among recent erectile dysfunction treatment deaths, "the majority, 97[%] to 99% of the deaths, are among people who are not vaccinated." "It's so sad for me on a daily basis to look at the number of deaths in the United States, knowing that these mortalities could have been prevented.

No one — no one — should die from erectile dysfunction treatment19 while we have an effective treatment." Researchers are hoping these early hot spots will be a wake-up call to communities with lower vaccination rates. "They should be heeding the warning that's coming out of Missouri and Arkansas and recognizing that they need to boost their vaccination rates," says Rubin of PolicyLab at Children's Hospital of Philadelphia. Nuzzo agrees. "There's a lot more that we can do to stop the spread of this viagra and to prevent people from being hospitalized or dying from it," she says. Alyson Hurt and Duy Nguyen of NPR and Emily Pond of the Johns Hopkins Center for Health Security contributed to this report.

Methodology To categorize hot spots, NPR analyzed daily updates of all counties' rankings on the Area of Concern Continuum from July 1 to July 7, provided by the Centers for Disease Control and Prevention. Sustained hot spots and hot spots were marked as such if they achieved that ranking at least once through the week. Among these hot spots, Johns Hopkins compared 30-day averages of new erectile dysfunction treatment cases to see where cases have seen sustained increases this month compared with the previous month. Vaccination data comes from county-level counts of fully vaccinated people as of July 7 provided by the CDC and the Texas Department of State Health Services. NPR excluded Georgia, Vermont, Virginia and West Virginia, because fewer than 80% of their vaccination records included a person's county of residence.

NPR used the National Center for Health Statistics 2013 Urban-Rural Classification Scheme to calculate average vaccination rates by county type, weighted by county population, both for all counties and for the hot spot counties. NPR calculated per-capita county hospitalization rates using seven-day counts of confirmed erectile dysfunction treatment hospital admissions for the weeks ending June 26 and July 3. This data is provided in Community Profile Reports published by the White House erectile dysfunction treatment team..

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Start Preamble Start Printed where to buy female viagra Page 58019 Centers for Medicare &. Medicaid Services (CMS), Department of Health where to buy female viagra and Human Services (HHS). Final rule.

Correction and correcting amendment where to buy female viagra. This document corrects technical and typographical errors in the final rule that appeared in the August 13, 2021, issue of the Federal Register titled “Medicare Program. Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2022 Rates where to buy female viagra.

Quality Programs and Medicare Promoting where to buy female viagra Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals. Changes to Medicaid Provider Enrollment. And Changes to the Medicare where to buy female viagra Shared Savings Program.”   Effective date.

The final rule corrections and correcting amendment are effective on October 19, 2021. Applicability date where to buy female viagra. The final rule corrections and correcting amendment are applicable to discharges occurring on or after October 1, 2021.

Start Further Info Donald Thompson, (410) 786-4487, and Michele Hudson, (410) 786-4487, Operating Prospective Payment, Wage Index, Hospital Geographic Reclassifications, Medicare Disproportionate Share Hospital (DSH) Payment Adjustment, Graduate Medical Education, and Critical Access Hospital (CAH) Issues where to buy female viagra. Mady Hue, where to buy female viagra (410) 786-4510, and Andrea Hazeley, (410) 786-3543, MS-DRG Classification Issues. Allison Pompey, (410) 786-2348, New Technology Add-On Payments Issues.

Julia Venanzi, julia.venanzi@cms.hhs.gov, Hospital Inpatient Quality Reporting and Hospital where to buy female viagra Value-Based Purchasing Programs. End Further Info End Preamble Start Supplemental Information I. Background In where to buy female viagra FR Doc.

2021-16519 of August 13, 2021 (86 FR 44774), there were a number of technical and typographical errors that are identified and corrected in this final rule correction and correcting amendment. The final rule corrections and where to buy female viagra correcting amendment are applicable to discharges occurring on or after October 1, 2021, as if they had been included in the document that appeared in the August 13, 2021, Federal Register. II where to buy female viagra.

Summary of Errors A. Summary of Errors in the Preamble On page 44878, we are correcting an inadvertent error in the reference to the number of technologies where to buy female viagra for which we proposed to allow a one-time extension of new technology add-on payments for fiscal year (FY) 2022. On page 44889, we are correcting an inadvertent typographical error in the International Classification of Disease, 10th Revision, Procedure Coding System (ICD-10-PCS) procedure code describing the percutaneous endoscopic repair of the esophagus.

On page 44960, in the table displaying the Medicare-Severity Diagnosis Related Groups (MS-DRGs) subject to the policy for replaced devices offered without cost or with a credit for FY 2022, we are correcting inadvertent typographical errors in the MS-DRGs describing Hip Replacement with Principal Diagnosis where to buy female viagra of Hip Fracture with and without MCC, respectively. On pages 45047, 45048, and 45049, in our discussion of the new technology add-on payments for FY 2022, we are correcting typographical and technical errors in referencing sections of the final rule. On page where to buy female viagra 45133, we are correcting an error in the maximum new technology add-on payment for a case involving the use of AprevoTM Intervertebral Body Fusion Device.

On page 45150, we inadvertently where to buy female viagra omitted ICD-10-CM codes from the list of diagnosis codes used to identify cases involving the use of the INTERCEPT Fibrinogen Complex that would be eligible for new technology add-on payments. On page 45157, we inadvertently omitted the ICD-10-CM diagnosis codes used to identify cases involving the use of FETROJA® for HABP/VABP. On page 45158, we inadvertently omitted the ICD-10-CM diagnosis codes where to buy female viagra used to identify cases involving the use of RECARBRIOTM for HABP/VABP.

On pages 45291, 45293, and 45294, in three tables that display previously established, newly updated, and estimated performance standards for measures included in the Hospital Value-Based Purchasing Program, we are correcting errors in the numerical values for all measures in the Clinical Outcomes Domain that appear in the three tables. On page 45312, in our discussion of payments for indirect and direct graduate where to buy female viagra medical education costs and Intern and Resident Information System (IRIS) data, we made a typographical error in our response to a comment. On page 45386, we made an inadvertent typographical error in our discussion of the Hospital Inpatient Quality Reporting (IQR) Program Severe Hyperglycemia electronic clinical quality measure (eCQM).

On page 45400, in our discussion of the Hospital Inpatient Quality Reporting (IQR) Program measures where to buy female viagra for fiscal year (FY) 2024, we mislabeled the table title and inadvertently included a measure not pertaining to the FY 2024 payment determination along with its corresponding footnote. On page 45404, in our discussion the Hospital Inpatient Quality Reporting (IQR) Program, where to buy female viagra we included a table with the measures for the FY 2025 payment determination. In the notes that immediately followed the table, we made a typographical error in the date associated with the voluntary reporting period for the Hybrid Hospital-Wide All-Cause Risk Standardized Mortality (HWM) measure.

B. Summary of Errors in the Regulations Text On page 45521, in the regulations text for § 413.24(f)(5)(i) introductory text and (f)(5)(i)(A) regarding cost reporting forms and teaching hospitals, we inadvertently omitted revisions that were discussed in the preamble. C.

Summary of Errors in the Addendum In the FY 2022 Hospital Inpatient Prospective Payment Systems and Long-Term Care Hospital Prospective Payment System (IPPS/LTCH PPS) final rule (85 FR 45166), we stated that we excluded the wage data for critical access hospitals (CAHs) as discussed in the FY 2004 IPPS final rule (68 FR 45397 through 45398). That is, any hospital that is designated as a CAH by 7 days prior to the publication of the preliminary wage index public use file (PUF) is excluded from the calculation Start Printed Page 58020 of the wage index. We inadvertently excluded a hospital that converted to CAH status after January 24, 2021, the cut-off date for CAH exclusion from the FY 2022 wage index.

(CMS Certification Number (CCN) 230118) Therefore, we restored the wage data for this hospital and included it in our calculation of the wage index. This correction necessitated the recalculation of the FY 2022 wage index for rural Michigan (rural state code 23), as reflected in Table 3, and affected the final FY 2022 wage index for rural Michigan 23 as well as the rural floor for the State of Michigan. As discussed in this section, the final FY 2022 IPPS wage index is used when determining total payments for purposes of all budget neutrality factors (except for the MS-DRG reclassification and recalibration budget neutrality factor) and the final outlier threshold.

We note, in the final rule, we correctly listed the number of hospitals with CAH status removed from the FY 2022 wage index (86 FR 45166), the number of hospitals used for the FY 2022 wage index (86 FR 45166) and the number of hospital occupational mix surveys used for the FY 2022 wage index (86 FR 45173). Additionally, the FY 2022 national average hourly wage (unadjusted for occupational mix) (86 FR 45172), the FY 2022 occupational mix adjusted national average hourly wage (86 FR 45173), and the FY 2022 national average hourly wages for the occupational mix nursing subcategories (86 FR 45174) listed in the final rule remain unchanged. Because the numbers and values noted previously are correctly stated in the preamble of the final rule and remain unchanged, we do not include any corrections in section IV.A.

Of this final rule correction and correcting amendment. We made an inadvertent error in the Medicare Geographic Classification Review Board (MGCRB) reclassification status of one hospital in the FY 2022 IPPS/LTCH PPS final rule. Specifically, CCN 360259 is incorrectly listed in Table 2 as reclassified to CBSA 19124.

The correct reclassification area is to its geographic “home” of CBSA 45780. This correction necessitated the recalculation of the FY 2022 wage index for CBSA 19124 and affected the final FY 2022 wage index with reclassification. The final FY 2022 IPPS wage index with reclassification is used when determining total payments for purposes of all budget neutrality factors (except for the MS-DRG reclassification and recalibration budget neutrality factor and the wage index budget neutrality adjustment factor) and the final outlier threshold.

As discussed further in section II.E. Of this final rule correction and correcting amendment, we made updates to the calculation of Factor 3 of the uncompensated care payment methodology to reflect updated information on hospital mergers received in response to the final rule and made corrections for report upload errors. Factor 3 determines the total amount of the uncompensated care payment a hospital is eligible to receive for a fiscal year.

This hospital-specific payment amount is then used to calculate the amount of the interim uncompensated care payments a hospital receives per discharge. Per discharge uncompensated care payments are included when determining total payments for purposes of all of the budget neutrality factors and the final outlier threshold. As a result, the revisions made to the calculation of Factor 3 to address additional merger information and report upload errors directly affected the calculation of total payments and required the recalculation of all the budget neutrality factors and the final outlier threshold.

Due to the correction of the combination of errors that are discussed previously (correcting the number of hospitals with CAH status, the correction to the MGCRB reclassification status of one hospital, and the revisions to Factor 3 of the uncompensated care payment methodology), we recalculated all IPPS budget neutrality adjustment factors, the fixed-loss cost threshold, the final wage indexes (and geographic adjustment factors (GAFs)), the national operating standardized amounts and capital Federal rate. We note that the fixed-loss cost threshold was unchanged after these recalculations. Therefore, we made conforming changes to the following.

On page 45532, the table titled “Summary of FY 2022 Budget Neutrality Factors”. On page 45537, the estimated total Federal capital payments and the estimated capital outlier payments. On pages 45542 and 45543, the calculation of the outlier fixed-loss cost threshold, total operating Federal payments, total operating outlier payments, the outlier adjustment to the capital Federal rate and the related discussion of the percentage estimates of operating and capital outlier payments.

On page 45545, the table titled “Changes from FY 2021 Standardized Amounts to the FY 2022 Standardized Amounts”. On pages 45553 through 45554, in our discussion of the determination of the Federal hospital inpatient capital related prospective payment rate update, due to the recalculation of the GAFs, we have made conforming corrections to the capital Federal rate. As a result of these changes, we also made conforming corrections in the table showing the comparison of factors and adjustments for the FY 2021 capital Federal rate and FY 2022 capital Federal rate.

As we noted in the final rule, the capital Federal rate is calculated using unrounded budget neutrality and outlier adjustment factors. The unrounded GAF/DRG budget neutrality factor, the unrounded Quartile/Cap budget neutrality factor, and the unrounded outlier adjustment to the capital Federal rate were revised because of these errors. However, after rounding these factors to 4 decimal places as displayed in the final rule, the rounded factors were unchanged from the final rule.

On pages 45570 and 45571, we are making conforming corrections to the national adjusted operating standardized amounts and capital standard Federal payment rate (which also include the rates payable to hospitals located in Puerto Rico) in Tables 1A, 1B, 1C, and 1D as a result of the conforming corrections to certain budget neutrality factors, as previously described. D. Summary of Errors in the Appendices On pages 45576 through 45580, 45582 through 45583, and 45598 through 45600, in our regulatory impact analyses, we have made conforming corrections to the factors, values, and tables and accompanying discussion of the changes in operating and capital IPPS payments for FY 2022 and the effects of certain IPPS budget neutrality factors as a result of the technical errors that lead to changes in our calculation of the operating and capital IPPS budget neutrality factors, outlier threshold, final wage indexes, operating standardized amounts, and capital Federal rate (as described in section II.C.

Of this final rule correction and correcting amendment). These conforming corrections include changes to the following. On pages 45576 through 45578, the table titled “Table I—Impact Analysis of Changes to the IPPS for Operating Costs for FY 2022”.

On pages 45582 and 45583, the table titled “Table II—Impact Analysis of Changes for FY 2022 Acute Care Hospital Operating Prospective Payment System (Payments per discharge)”. • On pages 45599 and 45600, the table titled “Table III—Comparison of Start Printed Page 58021 Total Payments per Case [FY 2021 Payments Compared to FY 2022 Payments]”. On pages 45584 and 45585 we are correcting the maximum new-technology add-on payment for a case involving the use of Fetroja, Recarbrio, Tecartus, and Abecma and related information in the untitled tables as well as making conforming corrections to the total estimated FY 2022 payments in the accompanying discussion of applications approved or conditionally approved for new technology add-on payments.

On pages 45587 through 45589, we are correcting the discussion of the “Effects of the Changes to Medicare DSH and Uncompensated Care Payments for FY 2022” for purposes of the Regulatory Impact Analysis in Appendix A of the FY 2022 IPPS/LTCH PPS final rule, including the table titled “Modeled Uncompensated Care Payments for Estimated FY 2022 DSHs by Hospital Type. Uncompensated Care Payments ($ in Millions)*—from FY 2021 to FY 2022”, in light of the corrections discussed in section II.E. Of this final rule correction and correcting amendment.

On pages 45610 and 45611, we are making conforming corrections to the estimated expenditures under the IPPS as a result of the corrections to the maximum new technology add-on payment for a case involving the use of AprevoTM Intervertebral Body Fusion Device, Fetroja, Recarbrio, Abecma, and Tecartus as described in this section and in section II.A. Of this final rule correction and correcting amendment. E.

Summary of Errors in and Corrections to Files and Tables Posted on the CMS Website We are correcting the errors in the following IPPS tables that are listed on pages 45569 and 45570 of the FY 2022 IPPS/LTCH PPS final rule and are available on the internet on the CMS website at https://www.cms.gov/​Medicare/​Medicare-Fee-for-Service-Payment/​AcuteInpatientPPS/​index.html. The tables that are available on the internet have been updated to reflect the revisions discussed in this final rule correction and correcting amendment. Table 2—Case-Mix Index and Wage Index Table by CCN-FY 2022 Final Rule.

As discussed in section II.C. Of this final rule correction and correcting amendment, we inadvertently excluded a hospital that converted to CAH status after January 24, 2021, the cut-off date for CAH exclusion from the FY 2022 wage index. (CMS Certification Number (CCN) 230118).

Therefore, we restored provider 230118 to the table. Also, as discussed in section II.C. Of this final rule correction and correcting amendment, CCN 360259 is incorrectly listed as reclassified to CBSA 19124.

The correct reclassification area is to its geographic “home” of CBSA 45780. In this table, we are correcting the columns titled “Wage Index Payment CBSA” and “MGCRB Reclass” to accurately reflect its reclassification to CBSA 45780. This correction necessitated the recalculation of the FY 2022 wage index for CBSA 19124.

As also discussed later in this section, because the wage indexes are one of the inputs used to determine the out-migration adjustment, some of the out-migration adjustments changed. Therefore, we are making corresponding changes to the affected values. Table 3.—Wage Index Table by CBSA—FY 2022 Final Rule.

As discussed in section II.C. Of this final rule correction and correcting amendment, we inadvertently excluded a hospital that converted to CAH status after January 24, 2021, the cut-off date for CAH exclusion from the FY 2022 wage index. (CMS Certification Number (CCN) 230118).

Therefore, we recalculated the wage index for rural Michigan (rural state code 23), as reflected in Table 3, as well as the rural floor for the State of Michigan. Also, as discussed in section II.C. Of this final rule correction and correcting amendment, CCN 360259 is incorrectly listed as reclassified to CBSA 19124.

The correct reclassification area is to its geographic “home” of CBSA 45780. In this table, we are correcting the values that changed as a result of these corrections as well as any corresponding changes. Table 4A.—List of Counties Eligible for the Out-Migration Adjustment under Section 1886(d)(13) of the Act—FY 2022 Final Rule.

As discussed in section II.C. Of this final rule correction and correcting amendment, we inadvertently excluded a hospital that converted to CAH status after January 24, 2021, the cut-off date for CAH exclusion from the FY 2022 wage index. (CMS Certification Number (CCN) 230118).

Also, as discussed in section II.C. Of this final rule correction and correcting amendment, CCN 360259 is incorrectly listed as reclassified to CBSA 19124. The correct reclassification area is to its geographic “home” of CBSA 45780.

As a result, as discussed previously, we are making changes to the FY 2022 wage indexes. Because the wage indexes are one of the inputs used to determine the out-migration adjustment, some of the out-migration adjustments changed. Therefore, we are making corresponding changes to some of the out-migration adjustments listed in Table 4A.

Table 6B.—New Procedure Codes—FY 2022. We are correcting this table to reflect the assignment of procedure codes XW033A7 (Introduction of ciltacabtagene autoleucel into peripheral vein, percutaneous approach, new technology group 7) and XW043A7 (Introduction of ciltacabtagene autoleucel into central vein, percutaneous approach, new technology group 7) to Pre-MDC MS-DRG 018 (Chimeric Antigen Receptor (CAR) T-cell and Other Immunotherapies). Table 6B inadvertently omitted Pre-MDC MS-DRG 018 in Column E (MS-DRG) for assignment of these codes.

Effective with discharges on and after April 1, 2022, conforming changes will be reflected in the Version 39.1 ICD-10 MS-DRG Definitions Manual and ICD-10 MS-DRG Grouper and Medicare Code Editor software. Table 6P.—ICD-10-CM and ICD-10-PCS Codes for MS-DRG Changes—FY 2022. We are correcting Table 6P.1d associated with the final rule to reflect three procedure codes submitted by the requestor that were inadvertently omitted, resulting in 79 procedure codes listed instead of 82 procedure codes as indicated in the final rule (see pages 44808 and 44809).

Table 18.—Final FY 2022 Medicare DSH Uncompensated Care Payment Factor 3. For the FY 2022 IPPS/LTCH PPS final rule, we published a list of hospitals that we identified to be subsection (d) hospitals and subsection (d) Puerto Rico hospitals projected to be eligible to receive interim uncompensated care payments for FY 2022. As stated in the FY 2022 IPPS/LTCH PPS final rule (86 FR 45249), we allowed the public an additional period after the issuance of the final rule to review and submit comments on the accuracy of the list of mergers that we identified in the final rule.

Based on the comments received during this additional period, we are updating this table to reflect the merger information received in response to the final rule and to revise the Factor 3 calculations for purposes of determining uncompensated care payments for the FY 2022 IPPS/LTCH PPS final rule. We are revising Factor 3 for all hospitals to reflect the updated merger information received in response to the final rule. We are also revising the amount of the total uncompensated care payment calculated for each DSH eligible hospital.

The total uncompensated care payment that a hospital receives is used to calculate the amount of the interim uncompensated care payments the hospital receives per discharge. Start Printed Page 58022 accordingly, we have also revised these amounts for all DSH eligible hospitals. These corrections will be reflected in Table 18 and the Medicare DSH Supplemental Data File.

Per discharge uncompensated care payments are included when determining total payments for purposes of all of the budget neutrality factors and the final outlier threshold. As a result, these corrections to uncompensated care payments required the recalculation of all the budget neutrality factors as well as the outlier fixed-loss cost threshold. We note that the fixed-loss cost threshold was unchanged after these recalculations.

In section IV.C. Of this final rule correction and correcting amendment, we have made corresponding revisions to the discussion of the “Effects of the Changes to Medicare DSH and Uncompensated Care Payments for FY 2022” for purposes of the Regulatory Impact Analysis in Appendix A of the FY 2022 IPPS/LTCH PPS final rule to reflect the corrections discussed previously and to correct minor typographical errors. The files that are available on the internet have been updated to reflect the corrections discussed in this final rule correction and correcting amendment.

In addition, we are correcting the inadvertent omission of the following 32 ICD-10-PCS codes describing percutaneous cardiovascular procedures involving one, two, three or four arteries from the GROUPER logic for MS-DRG 246 (Percutaneous Cardiovascular Procedures with Drug-Eluting Stent with MCC or 4+ Arteries or Stents) and MS-DRG 248 (Percutaneous Cardiovascular Procedures with Non-Drug-Eluting Stent with MCC or 4+ Arteries or Stents). ICD-10-PCS codeDescription02703Z6Dilation of coronary artery, one artery, bifurcation, percutaneous approach.02703ZZDilation of coronary artery, one artery, percutaneous approach.02704Z6Dilation of coronary artery, one artery, bifurcation, percutaneous endoscopic approach.02704ZZDilation of coronary artery, one artery, percutaneous endoscopic approach.02C03Z6Extirpation of matter from coronary artery, one artery, bifurcation, percutaneous approach.02C03ZZExtirpation of matter from coronary artery, one artery, percutaneous approach.02C04Z6Extirpation of matter from coronary artery, one artery, bifurcation, percutaneous endoscopic approach.02C04ZZExtirpation of matter from coronary artery, one artery, percutaneous endoscopic approach.02713Z6Dilation of coronary artery, two arteries, bifurcation, percutaneous approach.02713ZZDilation of coronary artery, two arteries, percutaneous approach.02714Z6Dilation of coronary artery, two arteries, bifurcation, percutaneous endoscopic approach.02714ZZDilation of coronary artery, two arteries, percutaneous endoscopic approach.02C13Z6Extirpation of matter from coronary artery, two arteries, bifurcation, percutaneous approach.02C13ZZExtirpation of matter from coronary artery, two arteries, percutaneous approach.02C14Z6Extirpation of matter from coronary artery, two arteries, bifurcation, percutaneous endoscopic approach.02C14ZZExtirpation of matter from coronary artery, two arteries, percutaneous endoscopic approach.02723Z6Dilation of coronary artery, three arteries, bifurcation, percutaneous approach.02723ZZDilation of coronary artery, three arteries, percutaneous approach.02724Z6Dilation of coronary artery, three arteries, bifurcation, percutaneous endoscopic approach.02724ZZDilation of coronary artery, three arteries, percutaneous endoscopic approach.02C23Z6Extirpation of matter from coronary artery, three arteries, bifurcation, percutaneous approach.02C23ZZExtirpation of matter from coronary artery, three arteries, percutaneous approach.02C24Z6Extirpation of matter from coronary artery, three arteries, bifurcation, percutaneous endoscopic approach.02C24ZZExtirpation of matter from coronary artery, three arteries, percutaneous endoscopic approach.02733Z6Dilation of coronary artery, four or more arteries, bifurcation, percutaneous approach.02733ZZDilation of coronary artery, four or more arteries, percutaneous approach.02734Z6Dilation of coronary artery, four or more arteries, bifurcation, percutaneous endoscopic approach.02734ZZDilation of coronary artery, four or more arteries, percutaneous endoscopic approach.02C33Z6Extirpation of matter from coronary artery, four or more arteries, bifurcation, percutaneous approach.02C33ZZExtirpation of matter from coronary artery, four or more arteries, percutaneous approach.02C34Z6Extirpation of matter from coronary artery, four or more arteries, bifurcation, percutaneous endoscopic approach.02C34ZZExtirpation of matter from coronary artery, four or more arteries, percutaneous endoscopic approach. We have corrected the ICD-10 MS-DRG Definitions Manual Version 39 and the ICD-10 MS-DRG GROUPER and MCE Version 39 Software to correctly reflect the inclusion of these codes in the arterial logic lists for MS-DRGs 246 and 248 for FY 2022.

III. Waiver of Proposed Rulemaking and Delay in Effective Date Under 5 U.S.C. 553(b) of the Administrative Procedure Act (APA), the agency is required to publish a notice of the proposed rulemaking in the Federal Register before the provisions of a rule take effect.

Similarly, section 1871(b)(1) of the Act requires the Secretary to provide for notice of the proposed rulemaking in the Federal Register and provide a period of not less than 60 days for public comment. In addition, section 553(d) of the APA, and section 1871(e)(1)(B)(i) of the Act mandate a 30-day delay in effective date after issuance or publication of a rule. Sections 553(b)(B) and 553(d)(3) of the APA provide for exceptions from the notice and comment and delay in effective date APA requirements.

In cases in which these exceptions apply, sections 1871(b)(2)(C) and 1871(e)(1)(B)(ii) of the Act provide exceptions from the notice and 60-day comment period and delay in effective date requirements of the Act as well. Section 553(b)(B) of the APA and section 1871(b)(2)(C) of the Act authorize an agency to dispense with normal rulemaking requirements for good cause if the agency makes a finding that the notice and comment process are impracticable, unnecessary, or contrary to the public interest. In addition, both section 553(d)(3) of the APA and section 1871(e)(1)(B)(ii) of the Act allow the agency to avoid the 30-day delay in effective date where such delay is contrary to the public interest and an agency includes a statement of support.

We believe that this final rule correction and correcting amendment does not constitute a rule that would be subject to the notice and comment or Start Printed Page 58023 delayed effective date requirements. This document corrects technical and typographical errors in the preamble, regulations text, addendum, payment rates, tables, and appendices included or referenced in the FY 2022 IPPS/LTCH PPS final rule, but does not make substantive changes to the policies or payment methodologies that were adopted in the final rule. As a result, this final rule correction and correcting amendment is intended to ensure that the information in the FY 2022 IPPS/LTCH PPS final rule accurately reflects the policies adopted in that document.

In addition, even if this were a rule to which the notice and comment procedures and delayed effective date requirements applied, we find that there is good cause to waive such requirements. Undertaking further notice and comment procedures to incorporate the corrections in this document into the final rule or delaying the effective date would be contrary to the public interest because it is in the public's interest for providers to receive appropriate payments in as timely a manner as possible, and to ensure that the FY 2022 IPPS/LTCH PPS final rule accurately reflects our policies. Furthermore, such procedures would be unnecessary, as we are not altering our payment methodologies or policies, but rather, we are simply implementing correctly the methodologies and policies that we previously proposed, requested comment on, and subsequently finalized.

This final rule correction and correcting amendment is intended solely to ensure that the FY 2022 IPPS/LTCH PPS final rule accurately reflects these payment methodologies and policies. Therefore, we believe we have good cause to waive the notice and comment and effective date requirements. Moreover, even if these corrections were considered to be retroactive rulemaking, they would be authorized under section 1871(e)(1)(A)(ii) of the Act, which permits the Secretary to issue a rule for the Medicare program with retroactive effect if the failure to do so would be contrary to the public interest.

As we have explained previously, we believe it would be contrary to the public interest not to implement the corrections in this final rule correction and correcting amendment because it is in the public's interest for providers to receive appropriate payments in as timely a manner as possible, and to ensure that the FY 2022 IPPS/LTCH PPS final rule accurately reflects our policies. IV. Correction of Errors In FR Doc.

2021-16519 of August 13, 2021 (86 FR 44774), we are making the following corrections. A. Correction of Errors in the Preamble 1.

On page 44878, second column, last paragraph, line 10, “15 technologies” is corrected to read “technologies.” 2. On page 44889, lower two-thirds of the page, third column, partial paragraph, line 10, the procedure code “0DQ540ZZ” is corrected to read “0DQ54ZZ.” 3. On page 44960, in the untitled table, last 2 lines are corrected to read as follows.

MDCMS-DRGMS-DRG title *         *         *         *         *         *         *08521Hip Replacement with Principal Diagnosis of Hip Fracture with MCC.08522Hip Replacement with Principal Diagnosis of Hip Fracture without MCC. 4. On page 45047.

A. Second column, first full paragraph, lines 21 through 24, the sentence “We summarize comments related to this comment solicitation and provide our responses as well as our finalized policy in section XXX of this final rule.” is corrected to read “We summarize comments related to this comment solicitation and provide our responses in section II.F.7. Of the preamble of this final rule.”.

B. Third column, first full paragraph, line 28, the reference “section XXX” is corrected to read “section II.F.8.”. 5.

On page 45048, second column, second full paragraph, lines 20 through 24, the sentence “We summarize comments related to this comment solicitation and provide our responses as well as our finalized policy in section XXX of this final rule.” is corrected to read “We summarize comments related to this comment solicitation and provide our responses in section II.F.7. Of the preamble of this final rule.”. 6.

(1) First full paragraph, line 12, the reference, “section XXX of this final rule” is corrected to read “section II.F.8. Of the preamble of this final rule”. (2) Second full paragraph, lines 1 and 2, the reference, “section XXX of this final rule” is corrected to read “section II.F.7.

J95.851 (Ventilator associated pneumonia) and one of the following. B96.1 (Klebsiella pneumoniae [K. Pneumoniae] as the cause of diseases classified elsewhere), B96.20 (Unspecified Escherichia coli [E.

Coli] as the cause of diseases classified elsewhere), B96.21 (Shiga toxin-producing Escherichia coli [E. Coli] [STEC] O157 as the cause of diseases classified elsewhere), B96.22 (Other specified Shiga toxin-producing Escherichia coli [E. Coli] [STEC] as the cause of diseases classified elsewhere), B96.23 (Unspecified Shiga toxin-producing Escherichia coli [E.

Coli] [STEC] as the cause of diseases classified elsewhere, B96.29 (Other Escherichia coli [E. Coli] as the cause of diseases classified elsewhere), B96.3 (Hemophilus influenzae [H. Influenzae] as the cause of diseases classified elsewhere, B96.5 (Pseudomonas (aeruginosa) (mallei) (pseudomallei) as the cause of diseases classified elsewhere), or B96.89 (Other specified bacterial agents as the cause of diseases classified elsewhere) for VABP.” 10.

On page 45158, third column, first partial paragraph, last line the phrase, “technology group 5).” is corrected to read “technology group 5) in combination with the following ICD-10-CM codes. Y95 (Nosocomial condition) and one of the following. J14.0 (Pneumonia due to Hemophilus influenzae) J15.0 (Pneumonia due to Klebsiella pneumoniae), J15.1 (Pneumonia due to Pseudomonas), J15.5 (Pneumonia due to Escherichia coli), J15.6 (Pneumonia due to other Gram-negative bacteria), or J15.8 (Pneumonia due to other specified bacteria) for HABP and ICD10-PCS codes.

XW033A6 (Introduction of cefiderocol antinfective into peripheral vein, percutaneous approach, new technology group 6) or XW043A6 (Introduction of cefiderocol anti-infective into central vein, percutaneous approach, new technology group 6) in combination with the following ICD-10-CM codes. J95.851 (Ventilator associated pneumonia) and one of the following. B96.1 (Klebsiella pneumoniae [K.

Pneumoniae] as the cause of diseases classified elsewhere), B96.20 (Unspecified Escherichia coli [E. Coli] as the cause of diseases classified elsewhere), B96.21 (Shiga toxin-producing Escherichia coli [E. Coli] Start Printed Page 58024 [STEC] O157 as the cause of diseases classified elsewhere), B96.22 (Other specified Shiga toxin-producing Escherichia coli [E.

Coli] [STEC] as the cause of diseases classified elsewhere), B96.23 (Unspecified Shiga toxin-producing Escherichia coli [E. Coli] [STEC] as the cause of diseases classified elsewhere, B96.29 (Other Escherichia coli [E. Coli] as the cause of diseases classified elsewhere), B96.3 (Hemophilus influenzae [H.

Influenzae] as the cause of diseases classified elsewhere, B96.5 (Pseudomonas (aeruginosa) (mallei)(pseudomallei) as the cause of diseases classified elsewhere), or B96.89 (Other specified bacterial agents as the cause of diseases classified elsewhere) for VABP.” 11. On page 45291, middle of the page, the table titled “Table V.H-11. Previously Established and Newly Updated Performance Standards for the FY 2024 Program Year” is corrected to read as follows.

Table V.H-11—Previously Established and Estimated Performance Standards for the FY 2024 Program YearMeasure short nameAchievement thresholdBenchmarkClinical Outcomes DomainMORT-30-AMI #0.8692470.887868MORT-30-HF #0.8823080.907773MORT-30-PN (updated cohort) #0.8402810.872976MORT-30-COPD #0.9164910.934002MORT-30-CABG #0.9694990.980319COMP-HIP-KNEE * #0.0253960.018159♢  As discussed in section V.H.4.b. Of this final rule, we are finalizing the updates to the FY 2024 baseline periods for measures included in the Person and Community Engagement, Safety, and Efficiency and Cost Reduction domains to use CY 2019. Therefore, the performance standards displayed in this table for the Safety domain measures were calculated using CY 2019 data.* Lower values represent better performance.#  Previously established performance standards.

12. On page 45293, top of the page, the table titled “V.H-13 Previously Established and Estimated Performance Standards for the FY 2025 Program Year” is corrected to read as follows. Table V.H-13—Previously Established and Estimated Performance Standards for the FY 2025 Program YearMeasure short nameAchievement thresholdBenchmarkClinical Outcomes DomainMORT-30-AMI #0.8726240.889994MORT-30-HF #0.8839900.910344MORT-30-PN (updated cohort) #0.8414750.874425MORT-30-COPD #0.9151270.932236MORT-30-CABG #0.9701000.979775COMP-HIP-KNEE * #0.0253320.017946* Lower values represent better performance.#  Previously established performance standards.

13. On page 45294, top of page, the table titled “V.H-14 Previously Established and Estimated Performance Standards for the FY 2026 Program Year” is corrected to read as follows. Table V.H-14—Previously Established and Estimated Performance Standards for the FY 2026 Program YearMeasure short nameAchievement thresholdBenchmarkClinical Outcomes DomainMORT-30-AMI #0.8744260.890687MORT-30-HF #0.8859490.912874MORT-30-PN (updated cohort) #0.8433690.877097MORT-30-COPD #0.9146910.932157MORT-30-CABG #0.9705680.980473COMP-HIP-KNEE * #0.0240190.016873* Lower values represent better performance.

Start Printed Page 58025#  Previously established performance standards. 14. On page 45312, second column, first full paragraph, lines 7 through 9, the phrase “rejection of the cost report if the submitted IRIS GME and IME FTEs do match” is corrected to read “rejection of the cost report if the submitted IRIS GME and IME FTEs do not match”.

15. On page 45386, third column, first full paragraph, line 12, the phrase “mellitus and who either” is corrected to read “mellitus, who”. 16.

On page 45400, top of the page, the table titled “Measures for the FY 2024 Payment Determination and Subsequent Years”, is corrected by— a. Correcting the title to read “Measures for the FY 2023 Payment Determination and Subsequent Years”. B.

Removing the heading “Claims and Electronic Data Measures” and the entry “Hybrid HWR**” (rows 20 and 21). C. Following the table, lines 3 through 8, removing the second table note.

17. On page 45404, bottom of the page, after the table titled “Measures for the FY 2025 Payment Determination and Subsequent Years”, in the third note to the table, line 10, the parenthetical phrase “(July 1, 2023-June 30, 2023)” is corrected to read “(July 1, 2022-June 30, 2023)”. B.

Correction of Errors in the Addendum 1. On page 45532, bottom of the page, the table titled “Summary of FY 2022 Budget Neutrality Factors” is corrected to read as follows. Summary of FY 2022 Budget Neutrality FactorsMS-DRG Reclassification and Recalibration Budget Neutrality Factor1.000107Wage Index Budget Neutrality Factor1.000715Reclassification Budget Neutrality Factor0.986741*Rural Floor Budget Neutrality Factor0.992868Rural Demonstration Budget Neutrality Factor0.999361Low Wage Index Hospital Policy Budget Neutrality Factor0.998029Transition Budget Neutrality Factor0.999859* The rural floor budget neutrality factor is applied to the national wage indexes while the rest of the budget neutrality adjustments are applied to the standardized amounts.

2. On page 45537, first column, first full paragraph, lines 4 through 10, the parenthetical phrase “(estimated capital outlier payments of $ 430,689,396 divided by (estimated capital outlier payments of $430,689,396 plus the estimated total capital Federal payment of $7,676,990,253)).” is corrected to read “(estimated capital outlier payments of $430,698,533 divided by (estimated capital outlier payments of $430,698,533 plus the estimated total capital Federal payment of $7,676,964,386)).”. 3.

On page 45542, third column, last paragraph, lines 23 and 24, the figure “$5,326,356,951” is corrected to read “$5,326,379,560”. 4. On page 45543.

A. Top of the page, first column, first partial paragraph. (1) Line 1, the figure “$100,164,666,975” is corrected to read “$100,165,281,272”.

(2) Line 17, the figure “$31,108” is corrected to read “$31,109”. B. Middle of the page, the untitled table is corrected to read as follows.

€ƒOperating standardized amountsCapital Federal rate *National0.9490.947078* The adjustment factor for the capital Federal rate includes an adjustment to the estimated percentage of FY 2022 capital outlier payments for capital outlier reconciliation, as discussed previously and in section III. A. 2 in the Addendum of this final rule.

5. On page 45545, the table titled “CHANGES FROM FY 2021 STANDARDIZED AMOUNTS TO THE FY 2022 STANDARDIZED AMOUNTS” is corrected to read as follows. Start Printed Page 58026 6.

On page 45553, second column, last paragraph, line 9, the figure “$472.60” is corrected to read “$472.59”. 7. On page 45554, top of the page, in the table titled “COMPARISON OF FACTORS AND ADJUSTMENTS.

FY 2021 CAPITAL FEDERAL RATE AND THE FY 2022 CAPITAL FEDERAL RATE”, the list entry (row 5) is corrected to read as follows. Comparison of Factors and Adjustments. FY 2021 Capital Federal Rate and the FY 2022 Capital Federal Rate FY 2021FY 2022ChangePercent change *         *         *         *         *         *         *Capital Federal Rate$466.21$472.591.01374  1.37 8.

On page 45570. A. The table titled “TABLE 1A.—NATIONAL ADJUSTED OPERATING STANDARDIZED AMOUNTS, LABOR/NONLABOR (67.6 PERCENT LABOR SHARE/32.4 PERCENT NONLABOR SHARE IF WAGE INDEX IS GREATER THAN 1)—FY 2022” is corrected to read as follows.

Table 1A—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (67.6 Percent Labor Share/32.4 Percent Nonlabor Share if Wage Index Is Greater Than 1)—FY 2022Hospital submitted quality data and is a meaningful EHR user (update = 2.0 percent)Hospital submitted quality data and is not a meaningful EHR user (update = −0.025 percent)Hospital did not submit quality data and is a meaningful EHR user (update = 1.325 percent)Hospital did not submit quality data and is not a meaningful EHR user (update = −0.7 percent)LaborNonlaborLaborNonlaborLaborNonlaborLaborNonlabor$4,138.24$1,983.41$4,056.08$1,944.03$4,110.85$1,970.28$4,028.70$1,930.91 Start Printed Page 58027 b. The table titled “TABLE 1B.—NATIONAL ADJUSTED OPERATING STANDARDIZED AMOUNTS, LABOR/NONLABOR (62 PERCENT LABOR SHARE/38 PERCENT NONLABOR SHARE IF WAGE INDEX IS LESS THAN OR EQUAL TO 1)—FY 2022” is corrected to read as follows. Table 1B—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (62 Percent Labor Share/38 Percent Nonlabor Share if Wage Index is Less Than or Equal to 1)—FY 2022Hospital submitted quality data and is a meaningful EHR user (update = 2.0 percent)Hospital submitted quality data and is not a meaningful EHR user (update = −0.025 percent)Hospital did not submit quality data and is a meaningful EHR user (update = 1.325 percent)Hospital did not submit quality data and is not a meaningful EHR user (update = −0.7 percent)LaborNonlaborLaborNonlaborLaborNonlaborLaborNonlabor$3,795.42$2,326.23$3,720.07$2,280.04$3,770.30$2,310.83$3,694.96$2,264.65 9.

On page 45571, the top of page. A. The table titled “Table 1C.—ADJUSTED OPERATING STANDARDIZED AMOUNTS FOR HOSPITALS IN PUERTO RICO, LABOR/NONLABOR (NATIONAL.

62 PERCENT LABOR SHARE/38 PERCENT NONLABOR SHARE BECAUSE WAGE INDEX IS LESS THAN OR EQUAL TO 1)—FY 2022” is corrected to read as follows. Table 1C—Adjusted Operating Standardized Amounts for Hospitals in Puerto Rico, Labor/Nonlabor (National. 62 Percent Labor Share/38 Percent Nonlabor Share Because Wage Index Is Less Than or Equal to 1)—FY 2022 Rates if wage index greater than 1Hospital is a meaningful EHR user and wage index less than or equal to 1 (update = 2.0)Hospital is NOT a meaningful EHR user and wage index less than or equal to 1 (update = 1.325)LaborNonlaborLaborNonlaborLaborNonlabor1  NationalNot ApplicableNot Applicable$3,795.42$2,326.23$3,770.30$2,310.831  For FY 2022, there are no CBSAs in Puerto Rico with a national wage index greater than 1.

B. The table titled “TABLE 1D.—CAPITAL STANDARD FEDERAL PAYMENT RATE—FY 2022” is corrected to read as follows. Table 1D—Capital Standard Federal Payment Rate—FY 2022 RateNational$472.59 C.

Correction of Errors in the Appendices 1. On pages 45576 through 45578, the table titled “Table I.—Impact Analysis of Changes to the IPPS for Operating Costs for FY 2022” is corrected to read as follows. Start Printed Page 58028 Start Printed Page 58029 Start Printed Page 58030 2.

On page 45579, third column, first paragraph, line 23, the figure “1.000712” is corrected to read “1.000715”. Start Printed Page 58031 3. On page 45580, lower three-fourths of the page, first column, third full paragraph, line 6, the figure “0.986737” is corrected to read “0.986741”.

4. On pages 45582 and 45583, the table titled “Table II.—Impact Analysis of Changes for FY 2022 Acute Care Hospital Operating Prospective Payment System (Payments Per Discharge)” is corrected to read as follows. Table II—Impact Analysis of Changes for FY 2022 Acute Care Hospital Operating Prospective Payment System[Payments per discharge] Number of hospitalsEstimated average FY 2021 payment per dischargeEstimated average FY 2022 payment per dischargeFY 2022 changes (1)(2)(3)(4)All Hospitals3,19513,10913,4482.6By Geographic Location:Urban hospitals2,45913,45413,8002.6Rural hospitals7369,90110,1782.8Bed Size (Urban):0-99 beds63410,72311,0112.7100-199 beds75411,01511,3052.6200-299 beds42712,25112,5512.4300-499 beds42113,49613,8472.6500 or more beds22316,56816,9922.6Bed Size (Rural):0-49 beds3118,5568,9214.350-99 beds2539,4199,6442.4100-149 beds949,78910,0332.5150-199 beds3910,51910,7882.6200 or more beds3911,46511,7842.8Urban by Region:New England11214,85815,2532.7Middle Atlantic30415,43215,8142.5East North Central38112,83813,1502.4West North Central16013,12113,4752.7South Atlantic40211,71012,0492.9East South Central14411,29011,5762.5West South Central36411,80612,0722.3Mountain17213,69814,0542.6Pacific37017,23017,6642.5Puerto Rico508,4918,6371.7Rural by Region:New England1913,99014,4633.4Middle Atlantic509,7369,9882.6East North Central11310,36110,5922.2West North Central8910,63810,9322.8South Atlantic1149,0329,3023East South Central1448,7328,9552.6West South Central1358,2928,5403Mountain4812,13412,3591.9Pacific2413,86514,5885.2By Payment Classification:Urban hospitals1,98312,67313,0032.6Rural areas1,21213,79614,1482.6Teaching Status:Nonteaching2,03110,67710,9632.7Fewer than 100 residents90712,38812,6942.5100 or more residents25718,93819,4372.6Urban DSH:Non-DSH50211,74912,0542.6100 or more beds1,22713,01513,3552.6Less than 100 beds3489,5599,8202.7Rural DSH:SCH26511,90612,2032.5RRC60814,38014,7472.6100 or more beds3012,11512,2981.5Less than 100 beds2157,7788,0253.2Urban teaching and DSH:Both teaching and DSH67914,11614,4832.6Teaching and no DSH7412,82513,1272.4No teaching and DSH89610,85011,1372.6No teaching and no DSH33410,82411,1102.6Special Hospital Types:Start Printed Page 58032RRC52314,47814,8592.6SCH30512,05312,3562.5MDH1539,1699,4042.6SCH and RRC15412,47512,7462.2MDH and RRC2710,62210,8532.2Type of Ownership:Voluntary1,88113,32113,6672.6Proprietary82811,47311,7692.6Government48614,10914,4662.5Medicare Utilization as a Percent of Inpatient Days:0-2564315,15815,5352.525-502,11012,92613,2682.650-6536710,77311,0102.2Over 65508,1328,4313.7FY 2022 Reclassifications by the Medicare Geographic Classification Review Board:All Reclassified Hospitals93413,59213,9442.6Non-Reclassified Hospitals2,26112,77213,1022.6Urban Hospitals Reclassified74914,26114,6192.5Urban Nonreclassified Hospitals1,72312,85113,1872.6Rural Hospitals Reclassified Full Year30010,08710,3412.5Rural Nonreclassified Hospitals Full Year4239,6109,9293.3All Section 401 Reclassified Hospitals53214,96815,3432.5Other Reclassified Hospitals (Section 1886(d)(8)(B))569,1499,4293.1 5.

On page 45584, bottom third of the page, third column, partial paragraph. A. Line 7, the figure “$151 million” is corrected to read “$158 million”.

B. Line 10, the figure “$50 million” is corrected to read “$57 million”. C.

Lines 15 and 16, the phrase “for which we are approving new technology add-on payments” is corrected to read “for which we are approving or conditionally approving new technology add-on payments”. 6. On page 45585.

A. Top third of the page. (1) In the untitled table, the third and fourth column headings and the entries at rows 6 and 9 are corrected to read as follows.

Technology nameEstimated casesFY 2022 NTAP amountEstimated FY 2022 total impactPathway (QIDP, LPAD, or breakthrough device) *         *         *         *         *         *         *Fetroja (HABP/VABP)379$8,579.84$3,251,759.36QIDP. *         *         *         *         *         *         *Recarbrio (HABP/VABP)9289,576.518,887,001.28QIDP. *         *         *         *         *         *         * (2) Following the first untitled table, second column, partial paragraph, last line, the figure “$498 million” is corrected to read “$514 million”. B. Middle third of the page, in the untitled table, the third and fourth column headings and the entries at rows 2 and 4 are corrected to read as follows.

Technology nameEstimated casesFY 2022 NTAP amountEstimated FY 2022 total impact *         *         *         *         *         *         *Abecma484$272,675.00$131,974,700.00 Start Printed Page 58033*         *         *         *         *         *         *Tecartus15259,350.003,890,250.00 *         *         *         *         *         *         * 7. On pages 45587 and 45588, the table titled “Modeled Uncompensated Care Payments for Estimated FY 2022 DSHs by Hospital Type. Model Uncompensated Care Payments ($ in Millions)—from FY 2021 to FY 2022” is corrected to read as follows.

Start Printed Page 58034 Start Printed Page 58035 8. On page 45588, lower half of the page, beginning with the second column, first full paragraph, line 1 with the phrase “Rural hospitals, in general, are projected to experience” and ending in the third column last paragraph with the phrase “15.22 percent. All” the paragraphs are corrected to read as follows.

€œRural hospitals, in general, are projected to experience larger decreases in uncompensated care payments than their urban counterparts. Overall, rural hospitals are projected to receive a 17.28 percent decrease in uncompensated care payments, which is a greater decrease than the overall hospital average, while urban hospitals are projected to receive a 12.99 percent decrease in uncompensated care payments, similar to the overall hospital average. By bed size, smaller rural hospitals are projected to receive the largest decreases in uncompensated care payments.

Rural hospitals with 0-99 beds are projected to receive an 18.97 percent payment decrease, and rural hospitals with 100-249 beds are projected to receive a 15.53 percent decrease. In contrast, larger rural hospitals with 250+ beds are projected to receive a 14.16 percent payment decrease. Among urban hospitals, the smallest urban hospitals, those with 0-99 and 100-249 beds, are projected to receive a decrease in uncompensated care payments that is greater than the overall hospital average, at 15.49 and 15.50 percent, respectively.

In contrast, the largest urban hospitals with 250+ beds are projected to receive a 12.02 percent decrease in uncompensated care payments, which is a smaller decrease than the overall hospital average. By region, rural hospitals are expected to receive larger than average decreases in uncompensated care payments in all Regions, except for rural hospitals in New England, which are projected to receive a decrease of 1.27 percent in uncompensated care payments, and rural hospitals in the East South Central Region, which are projected to receive a smaller than average decrease of 13.01 percent. Regionally, urban hospitals are projected to receive a more varied range of payment changes.

Urban hospitals in the New England, Middle Atlantic, and Pacific Regions are projected to receive larger than average decreases in uncompensated care payments. Urban hospitals in the South Atlantic, East North Central, West North Central, West South Central, and Mountain Regions, as well as hospitals in Puerto Rico are projected to receive smaller than average decreases in uncompensated care payments. Urban hospitals in the East South Central Region are projected to receive an average decrease in uncompensated care payments.

By payment classification, although hospitals in urban areas overall are expected to receive a 12.74 percent decrease in uncompensated care payments, hospitals in large urban areas are expected to see a decrease in uncompensated care payments of 13.52 percent, while hospitals in other urban areas are expected to receive a decrease in uncompensated care payments of 11.21 percent. Rural hospitals are projected to receive the largest decrease of 14.23 percent. Nonteaching hospitals are projected to receive a payment decrease of 13.4 percent, teaching hospitals with fewer than 100 residents are projected to receive a payment decrease of 12.94 percent, and teaching hospitals with 100+ residents have a projected payment decrease of 13.39 percent.

All of these decreases closely approximate the overall hospital average. Proprietary and voluntary hospitals are projected to receive smaller than average decreases of 11.56 and 12.61 percent respectively, while government hospitals are expected to receive a larger payment decrease of 15.21 percent. All”.

9. On page 45589, first column, first partial paragraph, the phrase “hospitals with less than 50 percent Medicare utilization are projected to receive decreases in uncompensated care payments consistent with the overall hospital average percent change, while hospitals with 50-65 percent and greater than 65 percent Medicare utilization are projected to receive larger decreases of 20.79 and 32.81 percent, respectively.” is corrected to read as follows. €œhospitals with less than 50 percent Medicare utilization are projected to receive decreases in uncompensated care payments consistent with the overall hospital average percent change, while hospitals with 50-65 percent and greater than 65 percent Medicare utilization are projected to receive larger decreases of 20.85 and 32.86 percent, respectively.” Start Printed Page 58036 10.

On page 45598, third column, last paragraph, lines 21 through 23, the sentence “The estimated percentage increase for both rural reclassified and nonreclassified hospitals is 1.4 percent.” is corrected to read “The estimated percentage increase for rural reclassified hospitals is 1.3 percent, while the estimated percentage increase for rural nonreclassified hospitals is 1.4 percent.” 11. On pages 45599 and 45600, the table titled “TABLE III.—COMPARISON OF TOTAL PAYMENTS PER CASE [FY 2021 PAYMENTS COMPARED TO FY 2022 PAYMENTS]” is corrected to read as follows. Start Printed Page 58037 Start Printed Page 58038 12.

On page 45610. A. Second column, first partial paragraph.

(1) Line 1, the figure “$2.293” is corrected to read “$2.316”. (2) Line 11, the figure “$0.65” is corrected to read “$0.68”. B.

Third column, last full paragraph, last line, the figure “$2.293” is corrected to read “$2.316”. 13. On page 45611, the table titled “Table V—ACCOUNTING STATEMENT.

CLASSIFICATION OF ESTIMATED EXPENDITURES UNDER THE IPPS FROM FY 2021 TO FY 2022” is corrected to read as follows. Start Printed Page 58039 CategoryTransfersAnnualized Monetized Transfers$2.316 billion.From Whom to WhomFederal Government to IPPS Medicare Providers. Start List of Subjects DiseasesHealth facilitiesMedicarePuerto RicoReporting and recordkeeping requirements End List of Subjects As noted in section II.B.

Of the preamble, the Centers for Medicare &. Medicaid Services is making the following correcting amendments to 42 CFR part 413. Start Part End Part Start Amendment Part1.

The authority citation for part 413 continues to read as follows. End Amendment Part Start Authority 42 U.S.C. 1302, 1395d(d), 1395f(b), 1395g, 1395l(a), (i), and (n), 1395x(v), 1395hh, 1395rr, 1395tt, and 1395ww.

End Authority Start Amendment Part2. Amend § 413.24 by. End Amendment Part Start Amendment Parta.

In paragraph (f)(5)(i) introductory text, removing the phrase “except as provided in paragraph (f)(5)(i)(E) of this section:” and adding in its place the phrase “except as provided in paragraphs (f)(5)(i)(A)( 2 )( ii ) and (f)(5)(i)(E) of this section:”. And End Amendment Part Start Amendment Partb. Revising paragraph (f)(5)(i)(A).

End Amendment Part The revision reads as follows. Adequate cost data and cost finding. * * * * * (f) * * * (5) * * * (i) * * * (A) Teaching hospitals.

For teaching hospitals, the Intern and Resident Information System (IRIS) data. ( 1 ) Data format. For cost reporting periods beginning on or after October 1, 2021, the IRIS data must be in the new XML IRIS format.

( 2 ) Resident counts. ( i ) Effective for cost reporting periods beginning on or after October 1, 2021, the IRIS data must contain the same total counts of direct GME FTE residents (unweighted and weighted) and IME FTE residents as the total counts of direct GME FTE and IME FTE residents reported in the provider's cost report. ( ii ) For cost reporting periods beginning on or after October 1, 2021, and before October 1, 2022, the cost report is not rejected if the requirement in paragraph (f)(5)(i)(A)( 2 )( i ) of this section is not met.

* * * * * Start Signature Karuna Seshasai, Executive Secretary to the Department, Department of Health and Human Services. End Signature End Supplemental Information BILLING CODE 4120-01-PBILLING CODE 4120-01-CBILLING CODE 4120-01-PBILLING CODE 4120-01-CBILLING CODE 4120-01-PBILLING CODE 4120-01-CBILLING CODE 4120-01-P[FR Doc. 2021-22724 Filed 10-19-21.

Start Preamble Start Printed Page 58019 Centers what do i need to buy viagra for Medicare &. Medicaid Services (CMS), Department of Health what do i need to buy viagra and Human Services (HHS). Final rule. Correction and correcting what do i need to buy viagra amendment. This document corrects technical and typographical errors in the final rule that appeared in the August 13, 2021, issue of the Federal Register titled “Medicare Program.

Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and what do i need to buy viagra the Long Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2022 Rates. Quality Programs and what do i need to buy viagra Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals. Changes to Medicaid Provider Enrollment. And Changes to what do i need to buy viagra the Medicare Shared Savings Program.”   Effective date. The final rule corrections and correcting amendment are effective on October 19, 2021.

Applicability date what do i need to buy viagra. The final rule corrections and correcting amendment are applicable to discharges occurring on or after October 1, 2021. Start Further Info Donald Thompson, (410) 786-4487, and Michele Hudson, (410) 786-4487, Operating Prospective Payment, Wage Index, Hospital Geographic Reclassifications, Medicare Disproportionate Share Hospital (DSH) Payment what do i need to buy viagra Adjustment, Graduate Medical Education, and Critical Access Hospital (CAH) Issues. Mady Hue, (410) 786-4510, and Andrea Hazeley, (410) 786-3543, MS-DRG Classification Issues what do i need to buy viagra. Allison Pompey, (410) 786-2348, New Technology Add-On Payments Issues.

Julia Venanzi, julia.venanzi@cms.hhs.gov, Hospital Inpatient Quality what do i need to buy viagra Reporting and Hospital Value-Based Purchasing Programs. End Further Info End Preamble Start Supplemental Information I. Background In what do i need to buy viagra FR Doc. 2021-16519 of August 13, 2021 (86 FR 44774), there were a number of technical and typographical errors that are identified and corrected in this final rule correction and correcting amendment. The final rule corrections and correcting amendment are applicable to discharges occurring on or after October 1, 2021, as if they had been included in the document that appeared in the August 13, 2021, Federal Register what do i need to buy viagra.

II what do i need to buy viagra. Summary of Errors A. Summary of Errors in the Preamble On page 44878, we are correcting an what do i need to buy viagra inadvertent error in the reference to the number of technologies for which we proposed to allow a one-time extension of new technology add-on payments for fiscal year (FY) 2022. On page 44889, we are correcting an inadvertent typographical error in the International Classification of Disease, 10th Revision, Procedure Coding System (ICD-10-PCS) procedure code describing the percutaneous endoscopic repair of the esophagus. On page 44960, in the table displaying the Medicare-Severity Diagnosis Related Groups (MS-DRGs) subject to the policy for replaced devices offered without cost or with a credit for FY 2022, we are correcting inadvertent typographical errors in the MS-DRGs describing Hip Replacement with Principal Diagnosis of what do i need to buy viagra Hip Fracture with and without MCC, respectively.

On pages 45047, 45048, and 45049, in our discussion of the new technology add-on payments for FY 2022, we are correcting typographical and technical errors in referencing sections of the final rule. On page 45133, we are correcting an error in the maximum new technology what do i need to buy viagra add-on payment for a case involving the use of AprevoTM Intervertebral Body Fusion Device. On page 45150, we inadvertently omitted ICD-10-CM codes from the list what do i need to buy viagra of diagnosis codes used to identify cases involving the use of the INTERCEPT Fibrinogen Complex that would be eligible for new technology add-on payments. On page 45157, we inadvertently omitted the ICD-10-CM diagnosis codes used to identify cases involving the use of FETROJA® for HABP/VABP. On page 45158, we inadvertently omitted the ICD-10-CM diagnosis what do i need to buy viagra codes used to identify cases involving the use of RECARBRIOTM for HABP/VABP.

On pages 45291, 45293, and 45294, in three tables that display previously established, newly updated, and estimated performance standards for measures included in the Hospital Value-Based Purchasing Program, we are correcting errors in the numerical values for all measures in the Clinical Outcomes Domain that appear in the three tables. On page 45312, in our discussion of payments for indirect and direct graduate medical education costs and Intern and what do i need to buy viagra Resident Information System (IRIS) data, we made a typographical error in our response to a comment. On page 45386, we made an inadvertent typographical error in our discussion of the Hospital Inpatient Quality Reporting (IQR) Program Severe Hyperglycemia electronic clinical quality measure (eCQM). On page 45400, in our discussion of the Hospital Inpatient Quality Reporting what do i need to buy viagra (IQR) Program measures for fiscal year (FY) 2024, we mislabeled the table title and inadvertently included a measure not pertaining to the FY 2024 payment determination along with its corresponding footnote. On page 45404, in our discussion the Hospital Inpatient Quality Reporting (IQR) Program, we included a table with the measures for the FY 2025 payment determination what do i need to buy viagra.

In the notes that immediately followed the table, we made a typographical error in the date associated with the voluntary reporting period for the Hybrid Hospital-Wide All-Cause Risk Standardized Mortality (HWM) measure. B. Summary of Errors in the Regulations Text On page 45521, in the regulations text for § 413.24(f)(5)(i) introductory text and (f)(5)(i)(A) regarding cost reporting forms and teaching hospitals, we inadvertently omitted revisions that were discussed in the preamble. C. Summary of Errors in the Addendum In the FY 2022 Hospital Inpatient Prospective Payment Systems and Long-Term Care Hospital Prospective Payment System (IPPS/LTCH PPS) final rule (85 FR 45166), we stated that we excluded the wage data for critical access hospitals (CAHs) as discussed in the FY 2004 IPPS final rule (68 FR 45397 through 45398).

That is, any hospital that is designated as a CAH by 7 days prior to the publication of the preliminary wage index public use file (PUF) is excluded from the calculation Start Printed Page 58020 of the wage index. We inadvertently excluded a hospital that converted to CAH status after January 24, 2021, the cut-off date for CAH exclusion from the FY 2022 wage index. (CMS Certification Number (CCN) 230118) Therefore, we restored the wage data for this hospital and included it in our calculation of the wage index. This correction necessitated the recalculation of the FY 2022 wage index for rural Michigan (rural state code 23), as reflected in Table 3, and affected the final FY 2022 wage index for rural Michigan 23 as well as the rural floor for the State of Michigan. As discussed in this section, the final FY 2022 IPPS wage index is used when determining total payments for purposes of all budget neutrality factors (except for the MS-DRG reclassification and recalibration budget neutrality factor) and the final outlier threshold.

We note, in the final rule, we correctly listed the number of hospitals with CAH status removed from the FY 2022 wage index (86 FR 45166), the number of hospitals used for the FY 2022 wage index (86 FR 45166) and the number of hospital occupational mix surveys used for the FY 2022 wage index (86 FR 45173). Additionally, the FY 2022 national average hourly wage (unadjusted for occupational mix) (86 FR 45172), the FY 2022 occupational mix adjusted national average hourly wage (86 FR 45173), and the FY 2022 national average hourly wages for the occupational mix nursing subcategories (86 FR 45174) listed in the final rule remain unchanged. Because the numbers and values noted previously are correctly stated in the preamble of the final rule and remain unchanged, we do not include any corrections in section IV.A. Of this final rule correction and correcting amendment. We made an inadvertent error in the Medicare Geographic Classification Review Board (MGCRB) reclassification status of one hospital in the FY 2022 IPPS/LTCH PPS final rule.

Specifically, CCN 360259 is incorrectly listed in Table 2 as reclassified to CBSA 19124. The correct reclassification area is to its geographic “home” of CBSA 45780. This correction necessitated the recalculation of the FY 2022 wage index for CBSA 19124 and affected the final FY 2022 wage index with reclassification. The final FY 2022 IPPS wage index with reclassification is used when determining total payments for purposes of all budget neutrality factors (except for the MS-DRG reclassification and recalibration budget neutrality factor and the wage index budget neutrality adjustment factor) and the final outlier threshold. As discussed further in section II.E.

Of this final rule correction and correcting amendment, we made updates to the calculation of Factor 3 of the uncompensated care payment methodology to reflect updated information on hospital mergers received in response to the final rule and made corrections for report upload errors. Factor 3 determines the total amount of the uncompensated care payment a hospital is eligible to receive for a fiscal year. This hospital-specific payment amount is then used to calculate the amount of the interim uncompensated care payments a hospital receives per discharge. Per discharge uncompensated care payments are included when determining total payments for purposes of all of the budget neutrality factors and the final outlier threshold. As a result, the revisions made to the calculation of Factor 3 to address additional merger information and report upload errors directly affected the calculation of total payments and required the recalculation of all the budget neutrality factors and the final outlier threshold.

Due to the correction of the combination of errors that are discussed previously (correcting the number of hospitals with CAH status, the correction to the MGCRB reclassification status of one hospital, and the revisions to Factor 3 of the uncompensated care payment methodology), we recalculated all IPPS budget neutrality adjustment factors, the fixed-loss cost threshold, the final wage indexes (and geographic adjustment factors (GAFs)), the national operating standardized amounts and capital Federal rate. We note that the fixed-loss cost threshold was unchanged after these recalculations. Therefore, we made conforming changes to the following. On page 45532, the table titled “Summary of FY 2022 Budget Neutrality Factors”. On page 45537, the estimated total Federal capital payments and the estimated capital outlier payments.

On pages 45542 and 45543, the calculation of the outlier fixed-loss cost threshold, total operating Federal payments, total operating outlier payments, the outlier adjustment to the capital Federal rate and the related discussion of the percentage estimates of operating and capital outlier payments. On page 45545, the table titled “Changes from FY 2021 Standardized Amounts to the FY 2022 Standardized Amounts”. On pages 45553 through 45554, in our discussion of the determination of the Federal hospital inpatient capital related prospective payment rate update, due to the recalculation of the GAFs, we have made conforming corrections to the capital Federal rate. As a result of these changes, we also made conforming corrections in the table showing the comparison of factors and adjustments for the FY 2021 capital Federal rate and FY 2022 capital Federal rate. As we noted in the final rule, the capital Federal rate is calculated using unrounded budget neutrality and outlier adjustment factors.

The unrounded GAF/DRG budget neutrality factor, the unrounded Quartile/Cap budget neutrality factor, and the unrounded outlier adjustment to the capital Federal rate were revised because of these errors. However, after rounding these factors to 4 decimal places as displayed in the final rule, the rounded factors were unchanged from the final rule. On pages 45570 and 45571, we are making conforming corrections to the national adjusted operating standardized amounts and capital standard Federal payment rate (which also include the rates payable to hospitals located in Puerto Rico) in Tables 1A, 1B, 1C, and 1D as a result of the conforming corrections to certain budget neutrality factors, as previously described. D. Summary of Errors in the Appendices On pages 45576 through 45580, 45582 through 45583, and 45598 through 45600, in our regulatory impact analyses, we have made conforming corrections to the factors, values, and tables and accompanying discussion of the changes in operating and capital IPPS payments for FY 2022 and the effects of certain IPPS budget neutrality factors as a result of the technical errors that lead to changes in our calculation of the operating and capital IPPS budget neutrality factors, outlier threshold, final wage indexes, operating standardized amounts, and capital Federal rate (as described in section II.C.

Of this final rule correction and correcting amendment). These conforming corrections include changes to the following. On pages 45576 through 45578, the table titled “Table I—Impact Analysis of Changes to the IPPS for Operating Costs for FY 2022”. On pages 45582 and 45583, the table titled “Table II—Impact Analysis of Changes for FY 2022 Acute Care Hospital Operating Prospective Payment System (Payments per discharge)”. • On pages 45599 and 45600, the table titled “Table III—Comparison of Start Printed Page 58021 Total Payments per Case [FY 2021 Payments Compared to FY 2022 Payments]”.

On pages 45584 and 45585 we are correcting the maximum new-technology add-on payment for a case involving the use of Fetroja, Recarbrio, Tecartus, and Abecma and related information in the untitled tables as well as making conforming corrections to the total estimated FY 2022 payments in the accompanying discussion of applications approved or conditionally approved for new technology add-on payments. On pages 45587 through 45589, we are correcting the discussion of the “Effects of the Changes to Medicare DSH and Uncompensated Care Payments for FY 2022” for purposes of the Regulatory Impact Analysis in Appendix A of the FY 2022 IPPS/LTCH PPS final rule, including the table titled “Modeled Uncompensated Care Payments for Estimated FY 2022 DSHs by Hospital Type. Uncompensated Care Payments ($ in Millions)*—from FY 2021 to FY 2022”, in light of the corrections discussed in section II.E. Of this final rule correction and correcting amendment. On pages 45610 and 45611, we are making conforming corrections to the estimated expenditures under the IPPS as a result of the corrections to the maximum new technology add-on payment for a case involving the use of AprevoTM Intervertebral Body Fusion Device, Fetroja, Recarbrio, Abecma, and Tecartus as described in this section and in section II.A.

Of this final rule correction and correcting amendment. E. Summary of Errors in and Corrections to Files and Tables Posted on the CMS Website We are correcting the errors in the following IPPS tables that are listed on pages 45569 and 45570 of the FY 2022 IPPS/LTCH PPS final rule and are available on the internet on the CMS website at https://www.cms.gov/​Medicare/​Medicare-Fee-for-Service-Payment/​AcuteInpatientPPS/​index.html. The tables that are available on the internet have been updated to reflect the revisions discussed in this final rule correction and correcting amendment. Table 2—Case-Mix Index and Wage Index Table by CCN-FY 2022 Final Rule.

As discussed in section II.C. Of this final rule correction and correcting amendment, we inadvertently excluded a hospital that converted to CAH status after January 24, 2021, the cut-off date for CAH exclusion from the FY 2022 wage index. (CMS Certification Number (CCN) 230118). Therefore, we restored provider 230118 to the table. Also, as discussed in section II.C.

Of this final rule correction and correcting amendment, CCN 360259 is incorrectly listed as reclassified to CBSA 19124. The correct reclassification area is to its geographic “home” of CBSA 45780. In this table, we are correcting the columns titled “Wage Index Payment CBSA” and “MGCRB Reclass” to accurately reflect its reclassification to CBSA 45780. This correction necessitated the recalculation of the FY 2022 wage index for CBSA 19124. As also discussed later in this section, because the wage indexes are one of the inputs used to determine the out-migration adjustment, some of the out-migration adjustments changed.

Therefore, we are making corresponding changes to the affected values. Table 3.—Wage Index Table by CBSA—FY 2022 Final Rule. As discussed in section II.C. Of this final rule correction and correcting amendment, we inadvertently excluded a hospital that converted to CAH status after January 24, 2021, the cut-off date for CAH exclusion from the FY 2022 wage index. (CMS Certification Number (CCN) 230118).

Therefore, we recalculated the wage index for rural Michigan (rural state code 23), as reflected in Table 3, as well as the rural floor for the State of Michigan. Also, as discussed in section II.C. Of this final rule correction and correcting amendment, CCN 360259 is incorrectly listed as reclassified to CBSA 19124. The correct reclassification area is to its geographic “home” of CBSA 45780. In this table, we are correcting the values that changed as a result of these corrections as well as any corresponding changes.

Table 4A.—List of Counties Eligible for the Out-Migration Adjustment under Section 1886(d)(13) of the Act—FY 2022 Final Rule. As discussed in section II.C. Of this final rule correction and correcting amendment, we inadvertently excluded a hospital that converted to CAH status after January 24, 2021, the cut-off date for CAH exclusion from the FY 2022 wage index. (CMS Certification Number (CCN) 230118). Also, as discussed in section II.C.

Of this final rule correction and correcting amendment, CCN 360259 is incorrectly listed as reclassified to CBSA 19124. The correct reclassification area is to its geographic “home” of CBSA 45780. As a result, as discussed previously, we are making changes to the FY 2022 wage indexes. Because the wage indexes are one of the inputs used to determine the out-migration adjustment, some of the out-migration adjustments changed. Therefore, we are making corresponding changes to some of the out-migration adjustments listed in Table 4A.

Table 6B.—New Procedure Codes—FY 2022. We are correcting this table to reflect the assignment of procedure codes XW033A7 (Introduction of ciltacabtagene autoleucel into peripheral vein, percutaneous approach, new technology group 7) and XW043A7 (Introduction of ciltacabtagene autoleucel into central vein, percutaneous approach, new technology group 7) to Pre-MDC MS-DRG 018 (Chimeric Antigen Receptor (CAR) T-cell and Other Immunotherapies). Table 6B inadvertently omitted Pre-MDC MS-DRG 018 in Column E (MS-DRG) for assignment of these codes. Effective with discharges on and after April 1, 2022, conforming changes will be reflected in the Version 39.1 ICD-10 MS-DRG Definitions Manual and ICD-10 MS-DRG Grouper and Medicare Code Editor software. Table 6P.—ICD-10-CM and ICD-10-PCS Codes for MS-DRG Changes—FY 2022.

We are correcting Table 6P.1d associated with the final rule to reflect three procedure codes submitted by the requestor that were inadvertently omitted, resulting in 79 procedure codes listed instead of 82 procedure codes as indicated in the final rule (see pages 44808 and 44809). Table 18.—Final FY 2022 Medicare DSH Uncompensated Care Payment Factor 3. For the FY 2022 IPPS/LTCH PPS final rule, we published a list of hospitals that we identified to be subsection (d) hospitals and subsection (d) Puerto Rico hospitals projected to be eligible to receive interim uncompensated care payments for FY 2022. As stated in the FY 2022 IPPS/LTCH PPS final rule (86 FR 45249), we allowed the public an additional period after the issuance of the final rule to review and submit comments on the accuracy of the list of mergers that we identified in the final rule. Based on the comments received during this additional period, we are updating this table to reflect the merger information received in response to the final rule and to revise the Factor 3 calculations for purposes of determining uncompensated care payments for the FY 2022 IPPS/LTCH PPS final rule.

We are revising Factor 3 for all hospitals to reflect the updated merger information received in response to the final rule. We are also revising the amount of the total uncompensated care payment calculated for each DSH eligible hospital. The total uncompensated care payment that a hospital receives is used to calculate the amount of the interim uncompensated care payments the hospital receives per discharge. Start Printed Page 58022 accordingly, we have also revised these amounts for all DSH eligible hospitals. These corrections will be reflected in Table 18 and the Medicare DSH Supplemental Data File.

Per discharge uncompensated care payments are included when determining total payments for purposes of all of the budget neutrality factors and the final outlier threshold. As a result, these corrections to uncompensated care payments required the recalculation of all the budget neutrality factors as well as the outlier fixed-loss cost threshold. We note that the fixed-loss cost threshold was unchanged after these recalculations. In section IV.C. Of this final rule correction and correcting amendment, we have made corresponding revisions to the discussion of the “Effects of the Changes to Medicare DSH and Uncompensated Care Payments for FY 2022” for purposes of the Regulatory Impact Analysis in Appendix A of the FY 2022 IPPS/LTCH PPS final rule to reflect the corrections discussed previously and to correct minor typographical errors.

The files that are available on the internet have been updated to reflect the corrections discussed in this final rule correction and correcting amendment. In addition, we are correcting the inadvertent omission of the following 32 ICD-10-PCS codes describing percutaneous cardiovascular procedures involving one, two, three or four arteries from the GROUPER logic for MS-DRG 246 (Percutaneous Cardiovascular Procedures with Drug-Eluting Stent with MCC or 4+ Arteries or Stents) and MS-DRG 248 (Percutaneous Cardiovascular Procedures with Non-Drug-Eluting Stent with MCC or 4+ Arteries or Stents). ICD-10-PCS codeDescription02703Z6Dilation of coronary artery, one artery, bifurcation, percutaneous approach.02703ZZDilation of coronary artery, one artery, percutaneous approach.02704Z6Dilation of coronary artery, one artery, bifurcation, percutaneous endoscopic approach.02704ZZDilation of coronary artery, one artery, percutaneous endoscopic approach.02C03Z6Extirpation of matter from coronary artery, one artery, bifurcation, percutaneous approach.02C03ZZExtirpation of matter from coronary artery, one artery, percutaneous approach.02C04Z6Extirpation of matter from coronary artery, one artery, bifurcation, percutaneous endoscopic approach.02C04ZZExtirpation of matter from coronary artery, one artery, percutaneous endoscopic approach.02713Z6Dilation of coronary artery, two arteries, bifurcation, percutaneous approach.02713ZZDilation of coronary artery, two arteries, percutaneous approach.02714Z6Dilation of coronary artery, two arteries, bifurcation, percutaneous endoscopic approach.02714ZZDilation of coronary artery, two arteries, percutaneous endoscopic approach.02C13Z6Extirpation of matter from coronary artery, two arteries, bifurcation, percutaneous approach.02C13ZZExtirpation of matter from coronary artery, two arteries, percutaneous approach.02C14Z6Extirpation of matter from coronary artery, two arteries, bifurcation, percutaneous endoscopic approach.02C14ZZExtirpation of matter from coronary artery, two arteries, percutaneous endoscopic approach.02723Z6Dilation of coronary artery, three arteries, bifurcation, percutaneous approach.02723ZZDilation of coronary artery, three arteries, percutaneous approach.02724Z6Dilation of coronary artery, three arteries, bifurcation, percutaneous endoscopic approach.02724ZZDilation of coronary artery, three arteries, percutaneous endoscopic approach.02C23Z6Extirpation of matter from coronary artery, three arteries, bifurcation, percutaneous approach.02C23ZZExtirpation of matter from coronary artery, three arteries, percutaneous approach.02C24Z6Extirpation of matter from coronary artery, three arteries, bifurcation, percutaneous endoscopic approach.02C24ZZExtirpation of matter from coronary artery, three arteries, percutaneous endoscopic approach.02733Z6Dilation of coronary artery, four or more arteries, bifurcation, percutaneous approach.02733ZZDilation of coronary artery, four or more arteries, percutaneous approach.02734Z6Dilation of coronary artery, four or more arteries, bifurcation, percutaneous endoscopic approach.02734ZZDilation of coronary artery, four or more arteries, percutaneous endoscopic approach.02C33Z6Extirpation of matter from coronary artery, four or more arteries, bifurcation, percutaneous approach.02C33ZZExtirpation of matter from coronary artery, four or more arteries, percutaneous approach.02C34Z6Extirpation of matter from coronary artery, four or more arteries, bifurcation, percutaneous endoscopic approach.02C34ZZExtirpation of matter from coronary artery, four or more arteries, percutaneous endoscopic approach. We have corrected the ICD-10 MS-DRG Definitions Manual Version 39 and the ICD-10 MS-DRG GROUPER and MCE Version 39 Software to correctly reflect the inclusion of these codes in the arterial logic lists for MS-DRGs 246 and 248 for FY 2022. III.

Waiver of Proposed Rulemaking and Delay in Effective Date Under 5 U.S.C. 553(b) of the Administrative Procedure Act (APA), the agency is required to publish a notice of the proposed rulemaking in the Federal Register before the provisions of a rule take effect. Similarly, section 1871(b)(1) of the Act requires the Secretary to provide for notice of the proposed rulemaking in the Federal Register and provide a period of not less than 60 days for public comment. In addition, section 553(d) of the APA, and section 1871(e)(1)(B)(i) of the Act mandate a 30-day delay in effective date after issuance or publication of a rule. Sections 553(b)(B) and 553(d)(3) of the APA provide for exceptions from the notice and comment and delay in effective date APA requirements.

In cases in which these exceptions apply, sections 1871(b)(2)(C) and 1871(e)(1)(B)(ii) of the Act provide exceptions from the notice and 60-day comment period and delay in effective date requirements of the Act as well. Section 553(b)(B) of the APA and section 1871(b)(2)(C) of the Act authorize an agency to dispense with normal rulemaking requirements for good cause if the agency makes a finding that the notice and comment process are impracticable, unnecessary, or contrary to the public interest. In addition, both section 553(d)(3) of the APA and section 1871(e)(1)(B)(ii) of the Act allow the agency to avoid the 30-day delay in effective date where such delay is contrary to the public interest and an agency includes a statement of support. We believe that this final rule correction and correcting amendment does not constitute a rule that would be subject to the notice and comment or Start Printed Page 58023 delayed effective date requirements. This document corrects technical and typographical errors in the preamble, regulations text, addendum, payment rates, tables, and appendices included or referenced in the FY 2022 IPPS/LTCH PPS final rule, but does not make substantive changes to the policies or payment methodologies that were adopted in the final rule.

As a result, this final rule correction and correcting amendment is intended to ensure that the information in the FY 2022 IPPS/LTCH PPS final rule accurately reflects the policies adopted in that document. In addition, even if this were a rule to which the notice and comment procedures and delayed effective date requirements applied, we find that there is good cause to waive such requirements. Undertaking further notice and comment procedures to incorporate the corrections in this document into the final rule or delaying the effective date would be contrary to the public interest because it is in the public's interest for providers to receive appropriate payments in as timely a manner as possible, and to ensure that the FY 2022 IPPS/LTCH PPS final rule accurately reflects our policies. Furthermore, such procedures would be unnecessary, as we are not altering our payment methodologies or policies, but rather, we are simply implementing correctly the methodologies and policies that we previously proposed, requested comment on, and subsequently finalized. This final rule correction and correcting amendment is intended solely to ensure that the FY 2022 IPPS/LTCH PPS final rule accurately reflects these payment methodologies and policies.

Therefore, we believe we have good cause to waive the notice and comment and effective date requirements. Moreover, even if these corrections were considered to be retroactive rulemaking, they would be authorized under section 1871(e)(1)(A)(ii) of the Act, which permits the Secretary to issue a rule for the Medicare program with retroactive effect if the failure to do so would be contrary to the public interest. As we have explained previously, we believe it would be contrary to the public interest not to implement the corrections in this final rule correction and correcting amendment because it is in the public's interest for providers to receive appropriate payments in as timely a manner as possible, and to ensure that the FY 2022 IPPS/LTCH PPS final rule accurately reflects our policies. IV. Correction of Errors In FR Doc.

2021-16519 of August 13, 2021 (86 FR 44774), we are making the following corrections. A. Correction of Errors in the Preamble 1. On page 44878, second column, last paragraph, line 10, “15 technologies” is corrected to read “technologies.” 2. On page 44889, lower two-thirds of the page, third column, partial paragraph, line 10, the procedure code “0DQ540ZZ” is corrected to read “0DQ54ZZ.” 3.

On page 44960, in the untitled table, last 2 lines are corrected to read as follows. MDCMS-DRGMS-DRG title *         *         *         *         *         *         *08521Hip Replacement with Principal Diagnosis of Hip Fracture with MCC.08522Hip Replacement with Principal Diagnosis of Hip Fracture without MCC. 4. On page 45047. A.

Second column, first full paragraph, lines 21 through 24, the sentence “We summarize comments related to this comment solicitation and provide our responses as well as our finalized policy in section XXX of this final rule.” is corrected to read “We summarize comments related to this comment solicitation and provide our responses in section II.F.7. Of the preamble of this final rule.”. B. Third column, first full paragraph, line 28, the reference “section XXX” is corrected to read “section II.F.8.”. 5.

On page 45048, second column, second full paragraph, lines 20 through 24, the sentence “We summarize comments related to this comment solicitation and provide our responses as well as our finalized policy in section XXX of this final rule.” is corrected to read “We summarize comments related to this comment solicitation and provide our responses in section II.F.7. Of the preamble of this final rule.”. 6. On page 45049. A.

Second column. (1) First full paragraph, line 12, the reference, “section XXX of this final rule” is corrected to read “section II.F.8. Of the preamble of this final rule”. (2) Second full paragraph, lines 1 and 2, the reference, “section XXX of this final rule” is corrected to read “section II.F.7. J95.851 (Ventilator associated pneumonia) and one of the following.

B96.1 (Klebsiella pneumoniae [K. Pneumoniae] as the cause of diseases classified elsewhere), B96.20 (Unspecified Escherichia coli [E. Coli] as the cause of diseases classified elsewhere), B96.21 (Shiga toxin-producing Escherichia coli [E. Coli] [STEC] O157 as the cause of diseases classified elsewhere), B96.22 (Other specified Shiga toxin-producing Escherichia coli [E. Coli] [STEC] as the cause of diseases classified elsewhere), B96.23 (Unspecified Shiga toxin-producing Escherichia coli [E.

Coli] [STEC] as the cause of diseases classified elsewhere, B96.29 (Other Escherichia coli [E. Coli] as the cause of diseases classified elsewhere), B96.3 (Hemophilus influenzae [H. Influenzae] as the cause of diseases classified elsewhere, B96.5 (Pseudomonas (aeruginosa) (mallei) (pseudomallei) as the cause of diseases classified elsewhere), or B96.89 (Other specified bacterial agents as the cause of diseases classified elsewhere) for VABP.” 10. On page 45158, third column, first partial paragraph, last line the phrase, “technology group 5).” is corrected to read “technology group 5) in combination with the following ICD-10-CM codes. Y95 (Nosocomial condition) and one of the following.

J14.0 (Pneumonia due to Hemophilus influenzae) J15.0 (Pneumonia due to Klebsiella pneumoniae), J15.1 (Pneumonia due to Pseudomonas), J15.5 (Pneumonia due to Escherichia coli), J15.6 (Pneumonia due to other Gram-negative bacteria), or J15.8 (Pneumonia due to other specified bacteria) for HABP and ICD10-PCS codes. XW033A6 (Introduction of cefiderocol antinfective into peripheral vein, percutaneous approach, new technology group 6) or XW043A6 (Introduction of cefiderocol anti-infective into central vein, percutaneous approach, new technology group 6) in combination with the following ICD-10-CM codes. J95.851 (Ventilator associated pneumonia) and one of the following. B96.1 (Klebsiella pneumoniae [K. Pneumoniae] as the cause of diseases classified elsewhere), B96.20 (Unspecified Escherichia coli [E.

Coli] as the cause of diseases classified elsewhere), B96.21 (Shiga toxin-producing Escherichia coli [E. Coli] Start Printed Page 58024 [STEC] O157 as the cause of diseases classified elsewhere), B96.22 (Other specified Shiga toxin-producing Escherichia coli [E. Coli] [STEC] as the cause of diseases classified elsewhere), B96.23 (Unspecified Shiga toxin-producing Escherichia coli [E. Coli] [STEC] as the cause of diseases classified elsewhere, B96.29 (Other Escherichia coli [E. Coli] as the cause of diseases classified elsewhere), B96.3 (Hemophilus influenzae [H.

Influenzae] as the cause of diseases classified elsewhere, B96.5 (Pseudomonas (aeruginosa) (mallei)(pseudomallei) as the cause of diseases classified elsewhere), or B96.89 (Other specified bacterial agents as the cause of diseases classified elsewhere) for VABP.” 11. On page 45291, middle of the page, the table titled “Table V.H-11. Previously Established and Newly Updated Performance Standards for the FY 2024 Program Year” is corrected to read as follows. Table V.H-11—Previously Established and Estimated Performance Standards for the FY 2024 Program YearMeasure short nameAchievement thresholdBenchmarkClinical Outcomes DomainMORT-30-AMI #0.8692470.887868MORT-30-HF #0.8823080.907773MORT-30-PN (updated cohort) #0.8402810.872976MORT-30-COPD #0.9164910.934002MORT-30-CABG #0.9694990.980319COMP-HIP-KNEE * #0.0253960.018159♢  As discussed in section V.H.4.b. Of this final rule, we are finalizing the updates to the FY 2024 baseline periods for measures included in the Person and Community Engagement, Safety, and Efficiency and Cost Reduction domains to use CY 2019.

Therefore, the performance standards displayed in this table for the Safety domain measures were calculated using CY 2019 data.* Lower values represent better performance.#  Previously established performance standards. 12. On page 45293, top of the page, the table titled “V.H-13 Previously Established and Estimated Performance Standards for the FY 2025 Program Year” is corrected to read as follows. Table V.H-13—Previously Established and Estimated Performance Standards for the FY 2025 Program YearMeasure short nameAchievement thresholdBenchmarkClinical Outcomes DomainMORT-30-AMI #0.8726240.889994MORT-30-HF #0.8839900.910344MORT-30-PN (updated cohort) #0.8414750.874425MORT-30-COPD #0.9151270.932236MORT-30-CABG #0.9701000.979775COMP-HIP-KNEE * #0.0253320.017946* Lower values represent better performance.#  Previously established performance standards. 13.

On page 45294, top of page, the table titled “V.H-14 Previously Established and Estimated Performance Standards for the FY 2026 Program Year” is corrected to read as follows. Table V.H-14—Previously Established and Estimated Performance Standards for the FY 2026 Program YearMeasure short nameAchievement thresholdBenchmarkClinical Outcomes DomainMORT-30-AMI #0.8744260.890687MORT-30-HF #0.8859490.912874MORT-30-PN (updated cohort) #0.8433690.877097MORT-30-COPD #0.9146910.932157MORT-30-CABG #0.9705680.980473COMP-HIP-KNEE * #0.0240190.016873* Lower values represent better performance. Start Printed Page 58025#  Previously established performance standards. 14. On page 45312, second column, first full paragraph, lines 7 through 9, the phrase “rejection of the cost report if the submitted IRIS GME and IME FTEs do match” is corrected to read “rejection of the cost report if the submitted IRIS GME and IME FTEs do not match”.

15. On page 45386, third column, first full paragraph, line 12, the phrase “mellitus and who either” is corrected to read “mellitus, who”. 16. On page 45400, top of the page, the table titled “Measures for the FY 2024 Payment Determination and Subsequent Years”, is corrected by— a. Correcting the title to read “Measures for the FY 2023 Payment Determination and Subsequent Years”.

B. Removing the heading “Claims and Electronic Data Measures” and the entry “Hybrid HWR**” (rows 20 and 21). C. Following the table, lines 3 through 8, removing the second table note. 17.

On page 45404, bottom of the page, after the table titled “Measures for the FY 2025 Payment Determination and Subsequent Years”, in the third note to the table, line 10, the parenthetical phrase “(July 1, 2023-June 30, 2023)” is corrected to read “(July 1, 2022-June 30, 2023)”. B. Correction of Errors in the Addendum 1. On page 45532, bottom of the page, the table titled “Summary of FY 2022 Budget Neutrality Factors” is corrected to read as follows. Summary of FY 2022 Budget Neutrality FactorsMS-DRG Reclassification and Recalibration Budget Neutrality Factor1.000107Wage Index Budget Neutrality Factor1.000715Reclassification Budget Neutrality Factor0.986741*Rural Floor Budget Neutrality Factor0.992868Rural Demonstration Budget Neutrality Factor0.999361Low Wage Index Hospital Policy Budget Neutrality Factor0.998029Transition Budget Neutrality Factor0.999859* The rural floor budget neutrality factor is applied to the national wage indexes while the rest of the budget neutrality adjustments are applied to the standardized amounts.

2. On page 45537, first column, first full paragraph, lines 4 through 10, the parenthetical phrase “(estimated capital outlier payments of $ 430,689,396 divided by (estimated capital outlier payments of $430,689,396 plus the estimated total capital Federal payment of $7,676,990,253)).” is corrected to read “(estimated capital outlier payments of $430,698,533 divided by (estimated capital outlier payments of $430,698,533 plus the estimated total capital Federal payment of $7,676,964,386)).”. 3. On page 45542, third column, last paragraph, lines 23 and 24, the figure “$5,326,356,951” is corrected to read “$5,326,379,560”. 4.

On page 45543. A. Top of the page, first column, first partial paragraph. (1) Line 1, the figure “$100,164,666,975” is corrected to read “$100,165,281,272”. (2) Line 17, the figure “$31,108” is corrected to read “$31,109”.

B. Middle of the page, the untitled table is corrected to read as follows. €ƒOperating standardized amountsCapital Federal rate *National0.9490.947078* The adjustment factor for the capital Federal rate includes an adjustment to the estimated percentage of FY 2022 capital outlier payments for capital outlier reconciliation, as discussed previously and in section III. A. 2 in the Addendum of this final rule.

5. On page 45545, the table titled “CHANGES FROM FY 2021 STANDARDIZED AMOUNTS TO THE FY 2022 STANDARDIZED AMOUNTS” is corrected to read as follows. Start Printed Page 58026 6. On page 45553, second column, last paragraph, line 9, the figure “$472.60” is corrected to read “$472.59”. 7.

On page 45554, top of the page, in the table titled “COMPARISON OF FACTORS AND ADJUSTMENTS. FY 2021 CAPITAL FEDERAL RATE AND THE FY 2022 CAPITAL FEDERAL RATE”, the list entry (row 5) is corrected to read as follows. Comparison of Factors and Adjustments. FY 2021 Capital Federal Rate and the FY 2022 Capital Federal Rate FY 2021FY 2022ChangePercent change *         *         *         *         *         *         *Capital Federal Rate$466.21$472.591.01374  1.37 8. On page 45570.

A. The table titled “TABLE 1A.—NATIONAL ADJUSTED OPERATING STANDARDIZED AMOUNTS, LABOR/NONLABOR (67.6 PERCENT LABOR SHARE/32.4 PERCENT NONLABOR SHARE IF WAGE INDEX IS GREATER THAN 1)—FY 2022” is corrected to read as follows. Table 1A—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (67.6 Percent Labor Share/32.4 Percent Nonlabor Share if Wage Index Is Greater Than 1)—FY 2022Hospital submitted quality data and is a meaningful EHR user (update = 2.0 percent)Hospital submitted quality data and is not a meaningful EHR user (update = −0.025 percent)Hospital did not submit quality data and is a meaningful EHR user (update = 1.325 percent)Hospital did not submit quality data and is not a meaningful EHR user (update = −0.7 percent)LaborNonlaborLaborNonlaborLaborNonlaborLaborNonlabor$4,138.24$1,983.41$4,056.08$1,944.03$4,110.85$1,970.28$4,028.70$1,930.91 Start Printed Page 58027 b. The table titled “TABLE 1B.—NATIONAL ADJUSTED OPERATING STANDARDIZED AMOUNTS, LABOR/NONLABOR (62 PERCENT LABOR SHARE/38 PERCENT NONLABOR SHARE IF WAGE INDEX IS LESS THAN OR EQUAL TO 1)—FY 2022” is corrected to read as follows. Table 1B—National Adjusted Operating Standardized Amounts, Labor/Nonlabor (62 Percent Labor Share/38 Percent Nonlabor Share if Wage Index is Less Than or Equal to 1)—FY 2022Hospital submitted quality data and is a meaningful EHR user (update = 2.0 percent)Hospital submitted quality data and is not a meaningful EHR user (update = −0.025 percent)Hospital did not submit quality data and is a meaningful EHR user (update = 1.325 percent)Hospital did not submit quality data and is not a meaningful EHR user (update = −0.7 percent)LaborNonlaborLaborNonlaborLaborNonlaborLaborNonlabor$3,795.42$2,326.23$3,720.07$2,280.04$3,770.30$2,310.83$3,694.96$2,264.65 9.

On page 45571, the top of page. A. The table titled “Table 1C.—ADJUSTED OPERATING STANDARDIZED AMOUNTS FOR HOSPITALS IN PUERTO RICO, LABOR/NONLABOR (NATIONAL. 62 PERCENT LABOR SHARE/38 PERCENT NONLABOR SHARE BECAUSE WAGE INDEX IS LESS THAN OR EQUAL TO 1)—FY 2022” is corrected to read as follows. Table 1C—Adjusted Operating Standardized Amounts for Hospitals in Puerto Rico, Labor/Nonlabor (National.

62 Percent Labor Share/38 Percent Nonlabor Share Because Wage Index Is Less Than or Equal to 1)—FY 2022 Rates if wage index greater than 1Hospital is a meaningful EHR user and wage index less than or equal to 1 (update = 2.0)Hospital is NOT a meaningful EHR user and wage index less than or equal to 1 (update = 1.325)LaborNonlaborLaborNonlaborLaborNonlabor1  NationalNot ApplicableNot Applicable$3,795.42$2,326.23$3,770.30$2,310.831  For FY 2022, there are no CBSAs in Puerto Rico with a national wage index greater than 1. B. The table titled “TABLE 1D.—CAPITAL STANDARD FEDERAL PAYMENT RATE—FY 2022” is corrected to read as follows. Table 1D—Capital Standard Federal Payment Rate—FY 2022 RateNational$472.59 C. Correction of Errors in the Appendices 1.

On pages 45576 through 45578, the table titled “Table I.—Impact Analysis of Changes to the IPPS for Operating Costs for FY 2022” is corrected to read as follows. Start Printed Page 58028 Start Printed Page 58029 Start Printed Page 58030 2. On page 45579, third column, first paragraph, line 23, the figure “1.000712” is corrected to read “1.000715”. Start Printed Page 58031 3. On page 45580, lower three-fourths of the page, first column, third full paragraph, line 6, the figure “0.986737” is corrected to read “0.986741”.

4. On pages 45582 and 45583, the table titled “Table II.—Impact Analysis of Changes for FY 2022 Acute Care Hospital Operating Prospective Payment System (Payments Per Discharge)” is corrected to read as follows. Table II—Impact Analysis of Changes for FY 2022 Acute Care Hospital Operating Prospective Payment System[Payments per discharge] Number of hospitalsEstimated average FY 2021 payment per dischargeEstimated average FY 2022 payment per dischargeFY 2022 changes (1)(2)(3)(4)All Hospitals3,19513,10913,4482.6By Geographic Location:Urban hospitals2,45913,45413,8002.6Rural hospitals7369,90110,1782.8Bed Size (Urban):0-99 beds63410,72311,0112.7100-199 beds75411,01511,3052.6200-299 beds42712,25112,5512.4300-499 beds42113,49613,8472.6500 or more beds22316,56816,9922.6Bed Size (Rural):0-49 beds3118,5568,9214.350-99 beds2539,4199,6442.4100-149 beds949,78910,0332.5150-199 beds3910,51910,7882.6200 or more beds3911,46511,7842.8Urban by Region:New England11214,85815,2532.7Middle Atlantic30415,43215,8142.5East North Central38112,83813,1502.4West North Central16013,12113,4752.7South Atlantic40211,71012,0492.9East South Central14411,29011,5762.5West South Central36411,80612,0722.3Mountain17213,69814,0542.6Pacific37017,23017,6642.5Puerto Rico508,4918,6371.7Rural by Region:New England1913,99014,4633.4Middle Atlantic509,7369,9882.6East North Central11310,36110,5922.2West North Central8910,63810,9322.8South Atlantic1149,0329,3023East South Central1448,7328,9552.6West South Central1358,2928,5403Mountain4812,13412,3591.9Pacific2413,86514,5885.2By Payment Classification:Urban hospitals1,98312,67313,0032.6Rural areas1,21213,79614,1482.6Teaching Status:Nonteaching2,03110,67710,9632.7Fewer than 100 residents90712,38812,6942.5100 or more residents25718,93819,4372.6Urban DSH:Non-DSH50211,74912,0542.6100 or more beds1,22713,01513,3552.6Less than 100 beds3489,5599,8202.7Rural DSH:SCH26511,90612,2032.5RRC60814,38014,7472.6100 or more beds3012,11512,2981.5Less than 100 beds2157,7788,0253.2Urban teaching and DSH:Both teaching and DSH67914,11614,4832.6Teaching and no DSH7412,82513,1272.4No teaching and DSH89610,85011,1372.6No teaching and no DSH33410,82411,1102.6Special Hospital Types:Start Printed Page 58032RRC52314,47814,8592.6SCH30512,05312,3562.5MDH1539,1699,4042.6SCH and RRC15412,47512,7462.2MDH and RRC2710,62210,8532.2Type of Ownership:Voluntary1,88113,32113,6672.6Proprietary82811,47311,7692.6Government48614,10914,4662.5Medicare Utilization as a Percent of Inpatient Days:0-2564315,15815,5352.525-502,11012,92613,2682.650-6536710,77311,0102.2Over 65508,1328,4313.7FY 2022 Reclassifications by the Medicare Geographic Classification Review Board:All Reclassified Hospitals93413,59213,9442.6Non-Reclassified Hospitals2,26112,77213,1022.6Urban Hospitals Reclassified74914,26114,6192.5Urban Nonreclassified Hospitals1,72312,85113,1872.6Rural Hospitals Reclassified Full Year30010,08710,3412.5Rural Nonreclassified Hospitals Full Year4239,6109,9293.3All Section 401 Reclassified Hospitals53214,96815,3432.5Other Reclassified Hospitals (Section 1886(d)(8)(B))569,1499,4293.1 5. On page 45584, bottom third of the page, third column, partial paragraph. A.

Line 7, the figure “$151 million” is corrected to read “$158 million”. B. Line 10, the figure “$50 million” is corrected to read “$57 million”. C. Lines 15 and 16, the phrase “for which we are approving new technology add-on payments” is corrected to read “for which we are approving or conditionally approving new technology add-on payments”.

6. On page 45585. A. Top third of the page. (1) In the untitled table, the third and fourth column headings and the entries at rows 6 and 9 are corrected to read as follows.

Technology nameEstimated casesFY 2022 NTAP amountEstimated FY 2022 total impactPathway (QIDP, LPAD, or breakthrough device) *         *         *         *         *         *         *Fetroja (HABP/VABP)379$8,579.84$3,251,759.36QIDP. *         *         *         *         *         *         *Recarbrio (HABP/VABP)9289,576.518,887,001.28QIDP. *         *         *         *         *         *         * (2) Following the first untitled table, second column, partial paragraph, last line, the figure “$498 million” is corrected to read “$514 million”. B. Middle third of the page, in the untitled table, the third and fourth column headings and the entries at rows 2 and 4 are corrected to read as follows. Technology nameEstimated casesFY 2022 NTAP amountEstimated FY 2022 total impact *         *         *         *         *         *         *Abecma484$272,675.00$131,974,700.00 Start Printed Page 58033*         *         *         *         *         *         *Tecartus15259,350.003,890,250.00 *         *         *         *         *         *         * 7. On pages 45587 and 45588, the table titled “Modeled Uncompensated Care Payments for Estimated FY 2022 DSHs by Hospital Type.

Model Uncompensated Care Payments ($ in Millions)—from FY 2021 to FY 2022” is corrected to read as follows. Start Printed Page 58034 Start Printed Page 58035 8. On page 45588, lower half of the page, beginning with the second column, first full paragraph, line 1 with the phrase “Rural hospitals, in general, are projected to experience” and ending in the third column last paragraph with the phrase “15.22 percent. All” the paragraphs are corrected to read as follows. €œRural hospitals, in general, are projected to experience larger decreases in uncompensated care payments than their urban counterparts.

Overall, rural hospitals are projected to receive a 17.28 percent decrease in uncompensated care payments, which is a greater decrease than the overall hospital average, while urban hospitals are projected to receive a 12.99 percent decrease in uncompensated care payments, similar to the overall hospital average. By bed size, smaller rural hospitals are projected to receive the largest decreases in uncompensated care payments. Rural hospitals with 0-99 beds are projected to receive an 18.97 percent payment decrease, and rural hospitals with 100-249 beds are projected to receive a 15.53 percent decrease. In contrast, larger rural hospitals with 250+ beds are projected to receive a 14.16 percent payment decrease. Among urban hospitals, the smallest urban hospitals, those with 0-99 and 100-249 beds, are projected to receive a decrease in uncompensated care payments that is greater than the overall hospital average, at 15.49 and 15.50 percent, respectively.

In contrast, the largest urban hospitals with 250+ beds are projected to receive a 12.02 percent decrease in uncompensated care payments, which is a smaller decrease than the overall hospital average. By region, rural hospitals are expected to receive larger than average decreases in uncompensated care payments in all Regions, except for rural hospitals in New England, which are projected to receive a decrease of 1.27 percent in uncompensated care payments, and rural hospitals in the East South Central Region, which are projected to receive a smaller than average decrease of 13.01 percent. Regionally, urban hospitals are projected to receive a more varied range of payment changes. Urban hospitals in the New England, Middle Atlantic, and Pacific Regions are projected to receive larger than average decreases in uncompensated care payments. Urban hospitals in the South Atlantic, East North Central, West North Central, West South Central, and Mountain Regions, as well as hospitals in Puerto Rico are projected to receive smaller than average decreases in uncompensated care payments.

Urban hospitals in the East South Central Region are projected to receive an average decrease in uncompensated care payments. By payment classification, although hospitals in urban areas overall are expected to receive a 12.74 percent decrease in uncompensated care payments, hospitals in large urban areas are expected to see a decrease in uncompensated care payments of 13.52 percent, while hospitals in other urban areas are expected to receive a decrease in uncompensated care payments of 11.21 percent. Rural hospitals are projected to receive the largest decrease of 14.23 percent. Nonteaching hospitals are projected to receive a payment decrease of 13.4 percent, teaching hospitals with fewer than 100 residents are projected to receive a payment decrease of 12.94 percent, and teaching hospitals with 100+ residents have a projected payment decrease of 13.39 percent. All of these decreases closely approximate the overall hospital average.

Proprietary and voluntary hospitals are projected to receive smaller than average decreases of 11.56 and 12.61 percent respectively, while government hospitals are expected to receive a larger payment decrease of 15.21 percent. All”. 9. On page 45589, first column, first partial paragraph, the phrase “hospitals with less than 50 percent Medicare utilization are projected to receive decreases in uncompensated care payments consistent with the overall hospital average percent change, while hospitals with 50-65 percent and greater than 65 percent Medicare utilization are projected to receive larger decreases of 20.79 and 32.81 percent, respectively.” is corrected to read as follows. €œhospitals with less than 50 percent Medicare utilization are projected to receive decreases in uncompensated care payments consistent with the overall hospital average percent change, while hospitals with 50-65 percent and greater than 65 percent Medicare utilization are projected to receive larger decreases of 20.85 and 32.86 percent, respectively.” Start Printed Page 58036 10.

On page 45598, third column, last paragraph, lines 21 through 23, the sentence “The estimated percentage increase for both rural reclassified and nonreclassified hospitals is 1.4 percent.” is corrected to read “The estimated percentage increase for rural reclassified hospitals is 1.3 percent, while the estimated percentage increase for rural nonreclassified hospitals is 1.4 percent.” 11. On pages 45599 and 45600, the table titled “TABLE III.—COMPARISON OF TOTAL PAYMENTS PER CASE [FY 2021 PAYMENTS COMPARED TO FY 2022 PAYMENTS]” is corrected to read as follows. Start Printed Page 58037 Start Printed Page 58038 12. On page 45610. A.

Second column, first partial paragraph. (1) Line 1, the figure “$2.293” is corrected to read “$2.316”. (2) Line 11, the figure “$0.65” is corrected to read “$0.68”. B. Third column, last full paragraph, last line, the figure “$2.293” is corrected to read “$2.316”.

13. On page 45611, the table titled “Table V—ACCOUNTING STATEMENT. CLASSIFICATION OF ESTIMATED EXPENDITURES UNDER THE IPPS FROM FY 2021 TO FY 2022” is corrected to read as follows. Start Printed Page 58039 CategoryTransfersAnnualized Monetized Transfers$2.316 billion.From Whom to WhomFederal Government to IPPS Medicare Providers. Start List of Subjects DiseasesHealth facilitiesMedicarePuerto RicoReporting and recordkeeping requirements End List of Subjects As noted in section II.B.

Of the preamble, the Centers for Medicare &. Medicaid Services is making the following correcting amendments to 42 CFR part 413. Start Part End Part Start Amendment Part1. The authority citation for part 413 continues to read as follows. End Amendment Part Start Authority 42 U.S.C.

1302, 1395d(d), 1395f(b), 1395g, 1395l(a), (i), and (n), 1395x(v), 1395hh, 1395rr, 1395tt, and 1395ww. End Authority Start Amendment Part2. Amend § 413.24 by. End Amendment Part Start Amendment Parta. In paragraph (f)(5)(i) introductory text, removing the phrase “except as provided in paragraph (f)(5)(i)(E) of this section:” and adding in its place the phrase “except as provided in paragraphs (f)(5)(i)(A)( 2 )( ii ) and (f)(5)(i)(E) of this section:”.

And End Amendment Part Start Amendment Partb. Revising paragraph (f)(5)(i)(A). End Amendment Part The revision reads as follows. Adequate cost data and cost finding. * * * * * (f) * * * (5) * * * (i) * * * (A) Teaching hospitals.

For teaching hospitals, the Intern and Resident Information System (IRIS) data. ( 1 ) Data format. For cost reporting periods beginning on or after October 1, 2021, the IRIS data must be in the new XML IRIS format. ( 2 ) Resident counts. ( i ) Effective for cost reporting periods beginning on or after October 1, 2021, the IRIS data must contain the same total counts of direct GME FTE residents (unweighted and weighted) and IME FTE residents as the total counts of direct GME FTE and IME FTE residents reported in the provider's cost report.

( ii ) For cost reporting periods beginning on or after October 1, 2021, and before October 1, 2022, the cost report is not rejected if the requirement in paragraph (f)(5)(i)(A)( 2 )( i ) of this section is not met. * * * * * Start Signature Karuna Seshasai, Executive Secretary to the Department, Department of Health and Human Services. End Signature End Supplemental Information BILLING CODE 4120-01-PBILLING CODE 4120-01-CBILLING CODE 4120-01-PBILLING CODE 4120-01-CBILLING CODE 4120-01-PBILLING CODE 4120-01-CBILLING CODE 4120-01-P[FR Doc. 2021-22724 Filed 10-19-21. 8:45 am]BILLING CODE 4120-01-C.