Notices. Notice with comment period

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BILLING CODE 4310-55-P 68 127 Wednesday, July 2, 2003 Notices Part III Department of Health and Human Services Centers for Medicare & Medicaid Services Medicare Program; Home Health Prospective Payment System Rate Update for FY 2004; Notice DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1473-NC] RIN 0938-AL94 Medicare Program; Home Health Prospective Payment System Rate Update for FY 2004 AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION: Notice with comment period. SUMMARY: This notice with comment period sets forth an update to the 60-day national episode rates and the national per-visit amounts under the Medicare prospective payment system for home health agencies. It also responds to public comments received on the June 28, 2002 notice with comment period, which set forth the home health prospective payment system rate update for FY 2003. EFFECTIVE DATE: Effective Date: The rate updates in this notice with comment period are effective on October 1, 2003. *Comment Period:* We will consider comments if we receive them at the appropriate address, as provided below, no later than 5 p.m. on August 29, 2003.

ADDRESSES: In commenting, please refer to file code CMS-1473-NC. Because of staff and resource limitations, we cannot accept comments by facsimile

(FAX)transmission. Mail written comments (one original and three copies) to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1473-NC, P.O. Box 8016, Baltimore, MD 21244-8016. Please allow sufficient time for mailed comments to be timely received in the event of delivery delays. If you prefer, you may deliver (by hand or courier) your written comments (one original and three copies) to one of the following addresses: Room 443-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201, or Room C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-1850. Comments mailed to the addresses indicated as appropriate for hand or courier delivery may be delayed and could be considered late. For information on viewing public comments, see the beginning of the SUPPLEMENTARY INFORMATION section. FOR FURTHER INFORMATION CONTACT: Chester Robinson,

(410)786-6959 or Susan Levy,

(410)786-9364. SUPPLEMENTARY INFORMATION: *Inspection of Public Comments:* Comments received timely will be available for public inspection as they are received, generally beginning approximately 3 weeks after publication of a document, at the headquarters of the Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244, Monday through Friday of each week from 8:30 a.m. to 4 p.m. To schedule an appointment to view public comments, phone

(410)786-7195. *Copies:* To order copies of the **Federal Register** containing this document, send your request to: New Orders, Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954. Specify the date of the issue requested and enclose a check or money order payable to the Superintendent of Documents, or enclose your Visa or Master Card number and expiration date. Credit card orders can also be placed by calling the order desk at

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(202)512-2250. The cost for each copy is $10. As an alternative, you can view and photocopy the **Federal Register** document at most libraries designated as Federal Depository Libraries and at many other public and academic libraries throughout the country that receive the **Federal Register** . This **Federal Register** document is also available from the **Federal Register** online database through GPO access, a service of the U.S. Government Printing Office. The Web site address is *http://www.access.gpo.gov/nara/index.html.* I. Background Legislation on Payment to Home Health Agencies A. Balanced Budget Act of 1997 The Balanced Budget Act of 1997 (BBA), Pub. L. 105-33, enacted on August 5, 1997, significantly changed the way Medicare pays for Medicare home health services. Until the implementation of a home health prospective payment system (HH PPS) on October 1, 2000, home health agencies

(HHAs)received payment under a cost-based reimbursement system. Section 4603 of the BBA governed the development of the HH PPS by adding section 1895 to the Social Security Act (the Act). Section 1895(b)(3)(B) of the Act requires the standard prospective payment amounts to be increased by a factor equal to the applicable home health market basket increase for FY 2004. B. System for Payment of Home Health Services Generally, Medicare makes payment under the HH PPS on the basis of a national standardized 60-day episode payment, adjusted for case mix and wage index. For episodes with four or fewer visits, Medicare pays on the basis of a national per-visit amount by discipline, referred to as a low utilization payment adjustment (LUPA). Medicare also adjusts the 60-day episode payment for certain intervening events that give rise to a partial episode payment adjustment or a significant change in condition adjustment. For certain cases that exceed a specific cost threshold, an outlier adjustment may also be available. For a complete and full description of the HH PPS as required by the BBA and as refined by the Omnibus Consolidated and Emergency Supplemental Appropriations Act (OCESAA) for FY 1999, Pub. L. 105-277, enacted on October 21, 1998, and the Medicare, Medicaid and SCHIP Balanced Budget Refinement Act of 1999, Pub. L. 106-113, enacted on November 29, 1999, see the July 3, 2000 HH PPS final rule (65 FR 41128). II. Analysis of and Responses To Comments on the Home Health Prospective Payment System June 28, 2002 Notice With Comment Period On June 28, 2002, we published a notice with comment period in the **Federal Register** (67 FR 43616) that set forth an update to the 60-day national episode rates and the national per-visit amounts under the Medicare prospective payment system for HHA for FY 2003. In this section, we respond to the 10 public comments that we received on the FY 2003 HH PPS update notice: *Comment* : Commenters disagreed with the statutory elimination of the 10 percent rural add-on set forth in section 508 of the Medicare, Medicaid, and SCHIP Benefits and Improvement Protection Act of 2000 (BIPA). *Response* : Section 508 of BIPA explicitly prescribes the time period (home health services furnished in a rural area ending on or after April 1, 2001, and before April 1, 2003) governing the 10 percent rural add-on. To conform to the statutory timeframe governing the rural add-on, the FY 2003 update notice published on June 28, 2002 included the expiration of the 10 percent rural add-on mid FY 2003. *Comment* : Commenters believe the actuarial assumptions of the behavior under the interim payment system

(IPS)were flawed and inadequate data were provided to the public, thereby compromising the meaning of the public comments. *Response* : We do not agree with the commenters. For FY 2003, we must comply with section 1895(b)(3)(A)(i)(III) of the Act (as re-designated by section 501 of BIPA) governing the payment amount under HH PPS. Section 1895(b)(3)(A)(i)(III) of the Act requires the Secretary to determine the payment amount for FY 2003 as if there were a 15 percent reduction to the limits under the IPS updated to FY 2003. The IPS ended with the implementation of home health PPS on October 1, 2000. Originally, the BBA 1997 required the base year PPS rates to be budget neutral to the IPS with the limits reduced by 15 percent. This requirement was delayed in subsequent legislation until section 501 of BIPA made it applicable to the home health PPS payment amount for FY 2003. As we explained in the FY 2003 update notice, the level by which actual payments to HHAs would be reduced by lowering the limits is not the same percent by which the IPS limits would be lowered. Our actuaries have used the 7 percent reduction in the PPS rates in every estimate for legislation since BBA 1997. Since it was the intention of the Congress to delay the cut it had already specified, we have simply captured the reductions in payments and carried those assumptions forward to the present. If our actuaries had attempted to impute the continued operation of the IPS until October 2002 given the amount of money available under the IPS limits that had not been spent, the actuaries may have well identified a larger reduction in payments. We did not believe such a result was the intent of the Congress. *Comment:* Some commenters urged us to postpone the FY 2003 reduction to the PPS rates until the Congress acts to repeal the reduction. *Response:* The FY 2003 update notice reflected the statutory requirements governing the home health PPS payment amount. The statutory requirements included both the required annual update to the PPS rates, according to section 1895(b)(3)(B) of the Act and section 1895(b)(3)(A)(i)(III) of the Act reflecting the IPS estimation. Both sections of the statute were effective October 1, 2002 for FY 2003. As the statute was not revised as of October 1, 2002, the FY 2003 update notice appropriately reflected the statutory requirements as of that date. *Comment:* Some commenters raised concerns about the assumptions used to determine the low utilization payment adjustment and corresponding impact on the episode rates. Commenters urged us to refine the methodology governing low utilization payment adjustments. *Response:* We understand the commenter's concerns. At this time, we are continuing to gather HH PPS data. As we gather more data, we will continue to monitor this issue. *Comment:* One commenter requested a detailed explanation of the market basket inflation update utilized in the FY 2003 PPS rate setting. The commenter points out that costs of home care services have increased recently due to new administrative responsibilities and reduced economies of scale due to lowered visit volume. As a result of staff shortages of nurses and home health aides, labor costs have increased. In addition, the HHAs have experienced rising premiums for liability insurance, workers compensation insurance, and employee health insurance. The commenter believes these factors should be incorporated in the market basket calculations and feels that the market basket update relies on too many proxies and surrogates for actual cost increases. *Response:* We agree with the commenter that showing the detail of the market basket increase for each year's payment update would be helpful. Thus, in this year's rule, we have added a table detailing the FY 2004 market basket forecast, which we believe adequately reflects the price increases for home health services (see Table 1 in section III.B. of this notice). *Comment:* Some commenters suggested that it is inappropriate and inequitable to use the previous fiscal year's pre-floor and pre-reclassified hospital wage index to adjust the current fiscal year's HH PPS rates. *Response:* We believe that the hospital wage index data we use is the most current data appropriate for adjusting HHA payments. As we have stated in both the FY 2002 and FY 2003 update notices, we use the most recent available pre-floor and pre-reclassified hospital wage index data available at the time of publication. *Comment:* A commenter requested clarification of our response to comments in the update notice published on June 28, 2002 in the **Federal Register** that states, “the statute does not contemplate a recalculation of the initial base year after the rates are established.” The commenter requested specific clarification of whether or not we were referring to the retrospective or prospective recalculation. *Response:* In our response to the comments on the June 2002 notice with comment period, we were referring to the commenter's request for a retrospective recalculation of the initial base year rates. *Comment:* A commenter is requesting specific data regarding the frequency of outlier payments, any Home Health Resource Group

(HHRG)connections to outlier payments, and the range of discipline-specific visits occurring in outlier cases and a re-evaluation of the outlier methodology. *Response:* We appreciate the comment. We are still developing the data requested by the commenter. We anticipate releasing and/or publishing the data upon their completion. *Comment:* We received comments on the pre-floor and pre-reclassified hospital wage index. Specifically, commenters noted that a reduction in wage index occurred in their area. *Response:* The HH PPS uses the pre-floor and pre-reclassified hospital wage index. Accordingly, we refer the commenters to the annual acute care hospital inpatient proposed and final rules, which provide detailed explanations of the costs that are included in the hospital wage index and how the hospital wage index is calculated. The hospital wage index is computed annually, using data collected annually from hospitals' Medicare cost reports. In addition, hospital data may differ from year-to-year, in part, because in labor market areas with few hospitals, annual variations in wage index values are typical. *Comment:* A commenter urged us to develop a home health specific wage index. *Response:* We have previously developed a home health specific wage index, which the industry did not support because it was viewed less favorably or less accurate than the pre-floor and pre-reclassified hospital wage index. Specifically, the home health industry had concerns with the methodology used to develop a home health specific wage index. These concerns coupled with our lack of applicable specific home health wage index led to our adoption of the hospital wage index in developing home health PPS. We will, however, continue to review the feasibility of this recommendation. III. Provisions of this Notice With Comment Period A. National Standardized 60-Day Episode Rate Medicare HH PPS has been effective since October 1, 2000. As set forth in the final rule published July 3, 2000 in the **Federal Register** (65 FR 41128), the unit of payment under Medicare HH PPS is a national standardized 60-day episode rate. As set forth in 42 CFR 484.220, we adjust the national standardized 60-day episode rate by case mix and wage index based on the site of service for the beneficiary. The FY 2004 HH PPS rates use the same case-mix methodology and application of the wage index adjustment to the labor portion of the HH PPS rates as set forth in the July 3, 2000 final rule. We multiply the national 60-day episode rate by the patient's applicable case-mix weight. We divide the case-mix adjusted amount into a labor and non-labor portion. We multiply the labor portion by the applicable wage index based on the site of service of the beneficiary. The labor portion of the rate continues to be .77668 and the non-labor portion of the rate continues to be .22332. We add the wage-adjusted portion to the non-labor portion yielding the case-mix and wage-adjusted 60-day episode rate subject to applicable adjustments. For FY 2004, we use again the design and case-mix methodology described in section III.G of the HH PPS July 3, 2000 final rule (65 FR 41192 through 41203). For FY 2004, we base the wage index adjustment to the labor portion of the PPS rates on the most recent pre-floor and pre-reclassified hospital wage index available at the time of publication of this notice, which is discussed in section III.C of this notice with comment period. As discussed in the July 3, 2000 HH PPS final rule, for episodes with four or fewer visits, Medicare pays the national per-visit amount by discipline, referred to as a LUPA. We update the national per-visit amounts by discipline annually by the applicable home health market basket. We adjust the national per-visit amount by the appropriate wage index based on the site of service for the beneficiary as set forth in § 484.230. We adjust the labor portion of the updated national per-visit amounts by discipline used to calculate the LUPA by the most recent pre-floor and pre-reclassified hospital wage index available at the time of publication of this notice, as discussed in section III.C of this notice with comment period. Medicare pays the 60-day case-mix and wage-adjusted episode payment on a split percentage payment approach. The split percentage payment approach includes an initial percentage payment and a final percentage payment as set forth in § 484.205(b)(1) and (b)(2). We may base the initial percentage payment on the submission of a request for anticipated payment and the final percentage payment on the submission of the claim for the episode, as discussed in regulations in § 409.43. The claim for the episode that the HHA submits for the final percentage payment determines the total payment amount for the episode and whether we make an applicable adjustment to the 60-day case-mix and wage-adjusted episode payment. The end date of the 60-day episode as reported on the claim determines the rate level at which Medicare will pay the claim for the fiscal period. In summary, we may adjust the 60-day case-mix and wage adjusted episode payment based on the information submitted on the claim to reflect the following: • A low utilization payment provided on a per-visit basis as set forth in § 484.205(c) and § 484.230. • A partial episode payment adjustment as set forth in § 484.205(d) and § 484.235. • A significant change in condition adjustment as set forth in § 484.205(e) and § 484.237. • An outlier payment as set forth in § 484.205(f) and § 484.240. This notice with comment period reflects the updated FY 2004 rates that are effective October 1, 2003. B. Structure and Methodology for FY 2004 Market Basket On July 1, 1996, we published a notice with comment period (61 FR 34349) in the **Federal Register** that fully explained the structure and methodology of the current home health market basket. The home health market basket captures the “pure price” change between payment years associated with providing home health services. In column 1 of Table 1, we have provided the 1993-based cost category components. In column 2 of Table 1, the weights in the home health market basket represent the average cost structure for freestanding HHAs for a base year, currently 1993. The weights are derived using Medicare Cost Reports for freestanding HHAs, augmented with additional information from the U.S. Department of Commerce, Bureau of Economic Analysis' Input-Output Tables. In column 3 of Table 1, the proxies used in the home health market basket are selected for their representativeness in tracking pure price changes and are generally publicly available price series from the U.S. Bureau of Labor Statistics. In column 4 of Table 1, the home health market basket percent change, or update, for FY 2004 is calculated as the weighted average of these specific price proxy changes. We feel that the home health market basket accurately reflects the price changes facing HHAs in providing an efficient level of care. Market baskets are periodically rebased and revised to a more current base year. To this end, we have been monitoring the most recently available data (for proposes of this analysis, we used 1999 data) on the distribution of costs in providing home health services and the appropriateness of our price proxies. Though this work is still very preliminary, the distribution of costs through 1999 does not appear to be dramatically different than the distribution of costs in the 1993 base year. We will continue to monitor these data, particularly data for the periods after prospective payment began, to determine the most appropriate time to rebase and revise the home health market basket. In Table 1 below, we set forth the 1993-based cost categories, weights, price proxies, and FY 2004 updates for the market basket forecast. In Table 2 below, we have provided a comparison of the FY 2003 and FY 2004 updates to the home health market basket. Table 1.—1993-Based Cost Categories, Weights, Price Proxies, and FY 2004 Updates Cost category 1993-based market basket weight Price proxy FY 2004 update (percent) Total 100.000 3.3 Compensation, including allocated Contract Services' labor 77.668 3.6 Wages and salaries, including allocated contract services' labor 64.226 HHA Occupational Wage Index 3.4 Employee benefits, including allocated contract services' labor 13.442 HHA Occupational Benefits Index 4.7 Operations & Maintenance 0.832 CPI-U Fuel & Other Utilities 0.5 Administrative & General, including allocated contract services' non-labor 9.569 2.7 Telephone 0.725 CPI-U Telephone 0.6 Paper & Printing 0.529 CPI-U Household Paper, Paper Products & Stationery Supplies 1.7 Postage 0.724 CPI-U Postage 1.8 Other Administrative & General, including allocated contract services' non-labor 7.591 CPI-U Services 3.0 Transportation 3.405 CPI-U Private Transportation −0.4 Capital-Related 3.204 2.6 Insurance 0.560 CPI-U Household Insurance 3.6 Fixed Capital 1.764 CPI-U Owner's Equivalent Rent 3.3 Movable Capital 0.880 PPI Machinery & Equipment 0.1 Other Expenses, including allocated contract services' nonlabor 5.322 CPI-U All Items Less Food & Energy 2.7 Source: Global Insights Inc., 1st Qtr, 2003; @USMACRO/MODTREND @CISSIM/TL0203.SIM Historical data through 4TH Qtr, 2002 Table 2.—1993-Based Cost Categories, Weights, and FY 2003 Update Versus FY 2004 Update Cost category 1993-based market basket weight FY03 update (as of 2001: 4th quarter forecast) (percent) FY04 update (as of 2003: 1st quarter forecast) (percent) Total 1000.000 3.2 3.3 Compensation, including allocated Contract Services' labor 77.668 3.4 3.6 Wages and salaries, including allocated contract services' labor 64.226 3.4 3.4 Employee benefits, including allocated contract services' labor 13.442 3.4 4.7 Operations & Maintenance 0.832 0.9 0.5 Administrative & General, including allocated contract services' non-labor 9.569 2.9 2.7 Telephone 0.725 0.4 0.6 Paper & Printing 0.529 0.9 1.7 Postage 0.724 3.6 1.8 Other Administrative & General, including allocated contract services' non-labor 7.591 3.1 3.0 Transportation 3.405 0.9 −0.4 Capital-Related 3.204 2.5 2.6 Insurance 0.560 3.0 3.6 Fixed Capital 1.764 3.4 3.3 Movable Capital 0.880 −0.3 0.1 Other Expenses, including allocated contract services' nonlabor 5.322 2.7 2.7 Source: Global Insights Inc., 1st Qtr, 2003; @USMACRO/MODTREND @CISSIM/TL0203.SIM Historical data through 4th Qtr, 2002; and 4th Qtr, 2001, @USMACRO/MODTREND @CISSIM/TRENDLONG1101 Historical data through 3rd Qtr, 2001. C. FY 2004 Update to the Home Health Market Basket Index Section 1895(b)(3)(B) of the Act requires the standard prospective payment amounts to be increased by a factor equal to the applicable home health market basket increase for FY 2004. This requirement has been codified in regulations in § 484.225. • *FY 2004 Adjustments* In calculating the annual update for the FY 2004 60-day episode rates, we first looked at the FY 2003 rates as a starting point. The FY 2003 national 60-day episode rate is $2,159.39. In order to calculate the FY 2004 national 60-day episode rate, we multiplied the FY 2003 national 60-day episode rate (2,159.39) by the applicable home health market basket update for FY 2004. The home health market basket increase for FY 2004 is 3.3 percent. We increased the FY 2003 amount by the FY 2004 home health market basket increase ($2,159.39 + 3.3 percent) to yield the updated FY 2004 national 60-day episode rate ($2,230.65) (see Table 3 below). Table 3.—National 60-Day Episode Amounts Updated by the Applicable Home Health Market Basket FY 2004 Prior to Case-Mix Adjustment, Wage Index Adjustment Based on the Site of Service for the Beneficiary or Applicable Payment Adjustment Total prospective payment amount per 60-day episode for FY 2003 Multiply by the applicable home health market basket increase Final FY 2004 updated national 60-day episode rate $2,159.39 ×1.033 $2,230.65 • *National Per-Visit Amounts Used To Pay LUPAs and Compute Imputed Costs Used in Outlier Calculations* . As discussed previously in this notice with comment period, the policies governing the LUPAs and outlier calculations set forth in the July 3, 2000 HH PPS final rule will continue during FY 2004. In calculating the annual update for the FY 2004 national per-visit amounts we use to pay LUPAs and to compute the imputed costs in outlier calculations, we again looked at the FY 2003 rates as a starting point. We then multiply those amounts by the applicable home health market basket increase for FY 2004 to yield the updated per-visit amounts for each home health discipline for FY 2004. (See Table 4 below.) Table 4.—National Per-Visit Amounts for LUPAs and Outlier Calculations Updated by the Applicable Home Health Market Basket Increase for FY 2004 Prior to Wage Index Adjustment Based on the Site of Service for the Beneficiary Home health discipline types Final per-visit amounts per 60-day episode for FY 2003 for LUPAs Multiply by applicable home health market basket Final per-visit payment amount per discipline for FY 2004 for LUPAs Home Health Aide $42.68 ×1.033 $44.09 Medical Social Services 151.11 ×1.033 156.10 Occupational Therapy 103.77 ×1.033 107.19 Physical Therapy 103.07 ×1.033 106.47 Skilled Nursing 94.27 ×1.033 97.38 Speech-Language Pathology 112.00 ×1.033 115.70 C. Hospital Wage Index Sections 1895(b)(4)(A)(ii) and (b)(4)(C) of the Act require the Secretary to establish area wage adjustment factors that reflect the relative level of wages and wage-related costs applicable to the furnishing of home health services and to provide appropriate adjustments to the episode payment amounts under HH PPS to account for area wage differences. We apply the appropriate wage index value to the labor portion of the HH PPS rates based on the geographic area in which the beneficiary received home health services. We determine each HHA's labor market area based on definitions of Metropolitan Statistical Areas

(MSAs)issued by the Office of Management and Budget (OMB). As discussed previously and set forth in the July 3, 2000 final rule, the statute provides that the wage adjustment factors may be the factors used by the Secretary for purposes of section 1886(d)(3)(E) of the Act for hospital wage adjustment factors. Again, as discussed in the July 3, 2000 final rule, we used the most recent pre-floor and pre-reclassified hospital wage index available at the time of publication of this notice to adjust the labor portion of the HH PPS rates based on the geographic area in which the beneficiary receives the home health services. We believe the use of the most recent available pre-floor and pre-reclassified hospital wage index data results in the appropriate adjustment to the labor portion of the costs as required by statute. (See addenda A and B of this notice with comment period, respectively, for the rural and urban hospital wage indexes. Furthermore, we have added an addendum C that shows a side-by-side comparison of the FY 2002 pre-floor and pre-reclassified hospital wage index and FY 2003 pre-floor and pre-reclassified hospital wage index for the FY 2004 HH PPS update notice. We believe that addendum C provides a clear illustration of changes in the wage index from FY 2002 and FY 2003.) IV. Waiver of Proposed Rulemaking We ordinarily publish a notice of proposed rulemaking in the **Federal Register** to provide a period for public comment before the provisions of a notice such as this take effect. We can waive this procedure, however, if we find good cause that a notice-and-comment procedure is impracticable, unnecessary, or contrary to the public interest and incorporates a statement of finding and its reasons in the notice issued. We believe it is unnecessary to undertake proposed notice and comment rulemaking as the statute requires annual updates to the HH PPS rates, the methodologies used to update the rate have been previously subject to public comment, and this notice reflects the application of previously established methodologies. This required annual update for the FY 2004 PPS rates is dictated by statute and does not require an exercise of discretion. Therefore, for good cause, we waive prior notice and comment procedures. As indicated previously, we are, however, providing a 60-day comment period for public comment. V. Collection of Information Requirements This document does not impose information collection and recordkeeping requirements. Consequently, it need not be reviewed by the Office of Management and Budget under the authority of the Paperwork Reduction Act of 1995 (44 U.S.C. 3501 *et seq.* ). VI. Response to Comments Because of the large number of items of correspondence we normally receive on **Federal Register** documents published for comment, we are not able to acknowledge or respond to them individually. We will consider all comments we receive by the date and time specified in the DATES section of the preamble, and, if we proceed with a subsequent document, we will respond to the major comments in the preamble to that document. VII. Regulatory Impact Analysis A. Overall Impact We have examined the impacts of this rule as required by Executive Order 12866 (September 1993, Regulatory Planning and Review), the Regulatory Flexibility Act

(RFA)(September 16, 1980, Pub. L. 96-354), section 1102(b) of the Social Security Act, the Unfunded Mandates Reform Act of 1995 (Pub. L. 104-4), and Executive Order 13132. Executive Order 12866 (as amended by Executive Order 13258, which merely reassigns responsibility of duties) directs agencies to assess all costs and benefits of available regulatory alternatives and, if regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). A regulatory impact analysis

(RIA)must be prepared for major rules with economically significant effects ($100 million or more in any 1 year). The update set forth in this notice with comment period applies to Medicare payments under HH PPS in FY 2004. Accordingly, the following analysis describes the impact in FY 2004 only. We estimate that there will be an additional $340 million in FY 2004 expenditures attributable to the FY 2004 market basket increase of 3.3 percent. The RFA requires agencies to analyze options for regulatory relief of small businesses. For purposes of the RFA, small entities include small businesses, nonprofit organizations, and government agencies. Most hospitals and most other providers and suppliers are small entities, either by nonprofit status or by having revenues of $6 million to $29 million or less annually (for details, see the Small Business Administration's regulation that set forth size standards for health care industries at 65 FR 69432). For purposes of the RFA, approximately 75 percent of HHAs are considered small businesses according to the Small Business Administration's size standards with total revenues of $11.5 million or less in 1 year. Individuals and States are not included in the definition of a small entity. As stated above, this notice with comment period provides an update to all HHAs for FY 2004 as required by statute. This notice will have a significant positive effect upon small entities. In addition, section 1102(b) of the Act requires us to prepare a regulatory impact analysis if a rule may have a significant impact on the operations of a substantial number of small rural hospitals. This analysis must conform to the provisions of section 604 of the RFA. For purposes of section 1102(b) of the Act, we define a small rural hospital as a hospital that is located outside of a metropolitan statistical area

(MSA)and has fewer than 100 beds. We have determined that this notice with comment period will not have a significant economic impact on the operations of a substantial number of small rural hospitals. Section 202 of the Unfunded Mandates Reform Act of 1995 also requires that agencies assess anticipated costs and benefits before issuing any rule that may result in expenditure in any 1 year by State, local, or tribal governments, in the aggregate, or by the private sector, of $110 million. We believe this notice will not mandate expenditures in that amount. Executive Order 13132 establishes certain requirements that an agency must meet when it promulgates a proposed rule (and subsequent final rule) that imposes substantial direct requirement costs on State and local governments, preempts State law, or otherwise has Federalism implications. We have reviewed this notice under the threshold criteria of Executive Order 13132, Federalism. We have determined that this notice would not have substantial direct effects on the rights, roles, and responsibilities of States. B. Anticipated Effects In accordance with the requirements of section 1895(b)(3) of the Act, we publish an update for each subsequent fiscal year that will provide an update to the payment rates. Section 1895(b)(3) of the Act requires us, for FY 2004, to increase the prospective payment amounts by the applicable home health market basket increase. The home health market basket increase for FY 2004 is 3.3 percent. Taking into account the provisions of section 1895(b)(3) of the Act, the increase for FY 2004 is 3.3 percent. 1. Effects on the Medicare Program This notice merely provides a percentage update to all Medicare HHAs. Therefore, we have not furnished any impact tables. We increase the payment to each Medicare HHA equally by the home health market basket update for FY 2004, as required by statute. There is no differential impact among provider types. The impact is in the aggregate. We estimate that there will be an additional $340 million in FY 2004 expenditures attributable to the FY 2004 market basket increase of 3.3 percent. Thus, the anticipated expenditures outlined in this notice exceed the $100 million annual threshold for a major rule as defined in Title 5, USC, section 804(2). The applicable home health market basket increase of 3.3 percent for FY 2004 applies to all Medicare participating in HHAs. We do not believe there is a differential impact due to the aggregate nature of the update. Table 5 FY 2004 update to home health PPS rates required by the act Additional FY 2004 medicare home health estimated expenditures due to annual update required by law Section 1895(b)(3)(B) of the Act requires HH PPS rates increased by applicable home health market basket increase (3.3 percent increase) $340 million. (Source: President's FY 2003 Budget) 2. Effects on Providers This notice will have a positive effect on providers of Medicare home health services by increasing their rate of Medicare payment. We do not anticipate specific effects on other providers. This notice reflects the statutorily required annual update to the HH PPS rates. We do not believe there is a differential impact due to the consistent and aggregate nature of the update. C. Alternatives Considered As discussed in section II, this notice with comment period reflects an annual update to the HH PPS rates as required by statute. Due to the lack of discretion provided in the statutory requirements governing this notice with comment period, we believe the statute provides no latitude for alternatives other than the approach set forth in this notice reflecting the FY 2004 annual update to the HH PPS rates. Other than the positive effect of the market basket increase, this notice with comment will not have a significant economic impact nor will it impose an additional burden on small entities. When a regulation or notice imposes additional burden on small entities, we are required under the RFA to examine alternatives for reducing burden. Since this notice with comment period will not impose an additional burden, we have not examined alternatives. D. Conclusion We have examined the economic impact of this notice with comment period on small entities and have determined that the economic impact is positive, significant, and that all HHAs will be affected. To the extent that small rural hospitals are affiliated with HHAs, the impact on these facilities will also be positive. Finally, we have determined that the economic effects described above are largely the result of the specific statutory provisions, which this notice serves to announce. In accordance with the provisions of notice with comment Executive Order 12866, this was reviewed by the Office of Management and Budget. (Catalog of Federal Domestic Assistance Program No. 93.773, Medicare—Hospital Insurance; and Program No. 93.774, Medicare—Supplementary Medical Insurance Program) Dated: February 21, 2003. Thomas A. Scully, Administrator, Centers for Medicare & Medicaid Services. Dated: March 26, 2003. Tommy G. Thompson, Secretary. Addendum A.—Wage Index for Rural Areas—Applicable Pre-Floor and Pre-Reclassified Hospital Wage Index (FY 2003) MSA name Wage index ALABAMA .7660 ALASKA 1.2293 ARIZONA .8493 ARKANSAS .7666 CALIFORNIA .9840 COLORADO .9015 CONNECTICUT 1.2394 DELAWARE .9128 FLORIDA .8814 GEORGIA .8230 GUAM .9611 HAWAII 1.0255 IDAHO .8747 ILLINOIS .8204 INDIANA .8755 IOWA .8315 KANSAS .7923 KENTUCKY .8079 LOUISIANA .7567 MAINE .8874 MARYLAND .8946 MASSACHUSETTS 1.1288 MICHIGAN .9000 MINNESOTA .9151 MISSISSIPPI .7680 MISSOURI .8021 MONTANA .8481 NEBRASKA .8204 NEVADA .9577 NEW HAMPSHIRE .9796 NEW JERSEY 1 NEW MEXICO .8872 NEW YORK .8542 NORTH CAROLINA .8666 NORTH DAKOTA .7788 OHIO .8613 OKLAHOMA .7590 OREGON 1.0303 PENNSYLVANIA .8462 PUERTO RICO .4356 RHODE ISLAND 1 SOUTH CAROLINA .8607 SOUTH DAKOTA .7815 TENNESSEE .7877 TEXAS .7821 UTAH .9312 VERMONT .9345 VIRGINIA .8504 VIRGIN ISLANDS .7845 WASHINGTON 1.0179 WEST VIRGINIA .7975 WISCONSIN .9162 WYOMING .9007 1 All counties within State are classified as Urban. Addendum B.—FY 2003 Wage Index for Urban Areas—Pre-Floor and Pre-Reclassified Hospital Wage Index MSA Urban area (constituent counties) Wage index 0040 Abilene, TX .7792 Taylor, TX 0060 Aguadilla, PR .4587 Aguada, PR Aguadilla, PR Moca, PR 0080 Akron, OH .9600 Portage, OH Summit, OH 0120 Albany, GA 1.0594 Dougherty, GA Lee, GA 0160 Albany-Schenectady-Troy, NY .8384 Albany, NY Montgomery, NY Rensselaer, NY Saratoga, NY Schenectady, NY Schoharie, NY 0200 Albuquerque, NM .9315 Bernalillo, NM Sandoval, NM Valencia, NM 0220 Alexandria, LA .7859 Rapides, LA 0240 Allentown-Bethlehem-Easton, PA .9735 Carbon, PA Lehigh, PA Northampton, PA 0280 Altoona, PA .9225 Blair, PA 0320 Amarillo, TX, Potter, TX .9034 Randall, TX 0380 Anchorage, AK 1.2358 Anchorage, AK 0440 Ann Arbor, MI 1.1103 Lenawee, MI Livingston, MI Washtenaw, MI 0450 Anniston, AL .8044 Calhoun, AL 0460 Appleton-Oshkosh-Neenah, WI .8997 Calumet, WI Outagamie, WI Winnebago, WI 0470 Arecibo, PR .4337 Arecibo, PR Camuy, PR Hatillo, PR 0480 Asheville, NC .9876 Buncombe, NC Madison, NC 0500 Athens, GA 1.0211 Clarke, GA Madison, GA Oconee, GA 0520 Atlanta, GA .9991 Barrow, GA Bartow, GA Carroll, GA Cherokee, GA Clayton, GA Cobb, GA Coweta, GA DeKalb, GA Douglas, GA Fayette, GA Forsyth, GA Fulton, GA Gwinnett, GA Henry, GA Newton, GA Paulding, GA Pickens, GA Rockdale, GA Spalding, GA Walton, GA 0560 Atlantic-Cape May, NJ 1.1017 Atlantic, NJ Cape May, NJ 0580 Auburn-Opelka, AL .8325 Lee, AL 0600 Augusta-Aiken, GA-SC 1.0264 Columbia, GA McDuffie, GA Richmond, GA Aiken, SC Edgefield, SC 0640 Austin-San Marcos, TX .9637 Bastrop, TX Caldwell, TX Hays, TX Travis, TX Williamson, TX 0680 Bakersfield, CA .9899 Kern, CA 0720 Baltimore, MD .9929 Anne Arundel, MD Baltimore City, MD Carroll, MD Harford, MD Howard, MD Queen Annes, MD 0733 Bangor, ME .9664 Penobscot, ME 0743 Barnstable-Yarmouth, MA 1.3202 Barnstable, MA 0760 Baton Rouge, LA .8294 Ascension, LA East Baton Rouge, LA Livingston, LA West Baton Rouge, LA 0840 Beaumont-Port Arthur, TX .8324 Hardin, TX Jefferson, TX Orange, TX 0860 Bellingham, WA 1.2282 Whatcom, WA 0870 Benton Harbor, MI .9042 Berrien, MI 0875 Bergen-Passaic, NJ 1.2150 Bergen, NJ Passaic, NJ 0880 Billings, MT .9022 Yellowstone, MT 0920 Biloxi-Gulfport-Pascagoula, MS .8757 Hancock, MS Harrison, MS Jackson, MS 0960 Binghamton, NY .8341 Broome, NY Tioga, NY 1000 Birmingham, AL .9222 Blount, AL Jefferson, AL St. Clair, AL Shelby, AL 1010 Bismarck, ND .7972 Burleigh, ND Morton, ND 1020 Bloomington, IN .8907 Monroe, IN 1040 Bloomington-Normal, IL .9109 McLean, IL 1080 Boise City, ID .9310 Ada, ID Canyon, ID 1123 Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH 1.1235 Bristol, MA Essex, MA Middlesex, MA Norfolk, MA Plymouth, MA Suffolk, MA Worcester, MA Hillsborough, NH Merrimack, NH Rockingham, NH Strafford, NH 1125 Boulder-Longmont, CO .9689 Boulder, CO 1145 Brazoria, TX .8535 Brazoria, TX 1150 Bremerton, WA .0944 Kitsap, WA 1240 Brownsville-Harlingen-San Benito, TX .8880 Cameron, TX 1260 Bryan-College Station, TX .8821 Brazos, TX 1280 Buffalo-Niagara Falls, NY .9365 Erie, NY Niagara, NY 1303 Burlington, VT 1.0052 Chittenden, VT Franklin, VT Grand Isle, VT 1310 Caguas, PR .4371 Caguas, PR Cayey, PR Cidra, PR Gurabo, PR San Lorenzo, PR 1320 Canton-Massillon, OH .8932 Carroll, OH Stark, OH 1350 Casper, WY .9690 Natrona, WY 1360 Cedar Rapids, IA .9056 Linn, IA 1400 Champaign-Urbana, IL 1.0635 Champaign, IL 1440 Charleston-North Charleston, SC .9235 Berkeley, SC Charleston, SC Dorchester, SC 1480 Charleston, WV .8898 Kanawha, WV Putnam, WV 1520 Charlotte-Gastonia-Rock Hill, NC-SC .9850 Cabarrus, NC Gaston, NC Lincoln, NC Mecklenburg, NC Rowan, NC Stanley, NC Union, NC York, SC 1540 Charlottesville, VA 1.0438 Albemarle, VA Charlottesville City, VA Fluvanna, VA Greene, VA 1560 Chattanooga, TN-GA .8976 Catoosa, GA Dade, GA Walker, GA Hamilton, TN Marion, TN Cheyenne, WY .8628 1580 Laramie, WY 1600 Chicago, IL 1.1044 Cook, IL DeKalb, IL DuPage, IL Grundy, IL Kane, IL Kendall, IL Lake, IL McHenry, IL Will, IL 1620 Chico-Paradise, CA .9745 Butte, CA 1640 Cincinnati, OH-KY-IN .9381 Dearborn, IN Ohio, IN Boone, KY Campbell, KY Gallatin, KY Grant, KY Kenton, KY Pendleton, KY Brown, OH Clermont, OH Hamilton, OH Warren, OH 1660 Clarksville-Hopkinsville, TN-KY .8406 Christian, KY Montgomery, TN 1680 Cleveland-Lorain-Elyria, OH .9670 Ashtabula, OH Cuyahoga, OH Geauga, OH Lake, OH Lorain, OH Medina, OH 1720 Colorado Springs, CO .9916 El Paso, CO 1740 Columbia, MO .8496 Boone, MO 1760 Columbia, SC .9307 Lexington, SC Richland, SC 1800 Columbus, GA-AL .8374 Russell, AL Chattahoochee, GA Harris, GA Muscogee, GA 1840 Columbus, OH .9751 Delaware, OH Fairfield, OH Franklin, OH Licking, OH Madison, OH Pickaway, OH 1880 Corpus Christi, TX .8729 Nueces, TX San Patricio, TX 1890 Corvallis, OR 1.1453 Benton, OR 1900 Cumberland, MD-WV .7847 Allegany, MD Mineral, WV 1920 Dallas, TX .9998 Collin, TX Dallas, TX Denton, TX Ellis, TX Henderson, TX Hunt, TX Kaufman, TX Rockwall, TX 1950 Danville, VA .8859 Danville City, VA Pittsylvania, VA 1960 Davenport-Moline-Rock Island, IA-IL .8835 Scott, IA Henry, IL Rock Island, IL 2000 Dayton-Springfield, OH .9282 Clark, OH Greene, OH Miami, OH Montgomery, OH 2020 Daytona Beach, FL .9062 Flagler, FL Volusia, FL 2030 Dacatur, AL .8973 Lawrence, AL Morgan, AL 2040 Dacatur, IL .8055 Macon, IL 2080 Denver, CO 1.0601 Adams, CO Arapahoe, CO Denver, CO Douglas, CO Jefferson, CO 2120 Des Moines, IA .8791 Dallas, IA Polk, IA Warren, IA 2160 Detroit, MI 1.0448 Lapeer, MI Macomb, MI Monroe, MI Oakland, MI St. Clair, MI Wayne, MI 2180 Dothan, AL .8137 Dale, AL Houston, AL 2190 Dover, DE .9356 Kent, DE 2200 Dubuque, IA .8795 Dubuque, IA 2240 Duluth-Superior, MN-WI 1.0368 St. Louis, MN Douglas, WI 2281 Dutchess County, NY 1.0684 Dutchess, NY 2290 Eau Claire, WI .8952 Chippewa, WI Eau Claire, WI 2320 El Paso, TX .9265 El Paso, TX 2330 Elkhart-Goshen, IN .9722 Elkhart, IN 2335 Elmira, NY .8416 Chemung, NY 2340 Enid, OK .8376 Garfield, OK 2360 Erie, PA .8925 Erie, PA 2400 Eugene-Springfield, OR 1.0944 Lane, OR 2440 Evansville-Henderson, IN-KY .8177 Posey, IN Vanderburgh, IN Warrick, IN Henderson, KY 2520 Fargo-Moorhead, ND-MN .9684 Clay, MN Cass, ND 2560 Fayetteville, NC .8889 Cumberland, NC 2580 Fayetteville-Springdale-Rogers, AR .8100 Benton, AR Washington, AR 2620 Flagstaff, AZ-UT 1.0682 Coconino, AZ Kane, UT 2640 Flint, MI 1.1135 Genesee, MI 2650 Florence, AL .7792 Colbert, AL Lauderdale, AL 2655 Florence, SC .8780 Florence, SC 2670 Fort Collins-Loveland, CO 1.0066 Larimer, CO 2680 Ft. Lauderdale, FL 1.0297 Broward, FL 2700 Fort Myers-Cape Coral, FL .9680 Lee, FL 2710 Fort Pierce-Port St. Lucie, FL .9823 Martin, FL St. Lucie, FL 2720 Fort Smith, AR-OK .7895 Crawford, AR Sebastian, AR Sequoyah, OK 2750 Fort Walton Beach, FL .9693 Okaloosa, FL 2760 Fort Wayne, IN .9457 Adams, IN Allen, IN De Kalb, IN Huntington, IN Wells, IN Whitley, IN 2800 Forth Worth-Arlington, TX .9446 Hood, TX Johnson, TX Parker, TX Tarrant, TX 2840 Fresno, CA 1.0216 Fresno, CA Madera, CA 2880 Gadsden, AL .8505 Etowah, AL 2900 Gainesville, FL .9871 Alachua, FL 2920 Galveston-Texas City, TX .9465 Galveston, TX 2960 Gary, IN .9584 Lake, IN Porter, IN 2975 Glens Falls, NY .8281 Warren, NY Washington, NY 2980 Goldsboro, NC .8892 Wayne, NC 2985 Grand Forks, ND-MN .8897 Polk, MN Grand Forks, ND 2995 Grand Junction, CO .9456 Mesa, CO 3000 Grand Rapids-Muskegon-Holland, MI .9525 Allegan, MI Kent, MI Muskegon, MI Ottawa, MI 3040 Great Falls, MT .8950 Cascade, MT 3060 Greeley, CO .9237 Weld, CO 3080 Green Bay, WI .9502 Brown, WI 3120 Greensboro-Winston-Salem-High Point, .9282 NC Alamance, NC Davidson, NC Davie, NC Forsyth, NC Guilford, NC Randolph, NC Stokes, NC Yadin, NC 3150 Greenville, NC .9100 Pitt, NC 3160 Greenville, Spartanburg-Anderson, SC .9122 Anderson, SC Cherokee, SC Greenville, SC Pickens, SC Spartanburg, SC 3180 Hagerstown, MD .9268 Washington, MD 3200 Hamilton-Middletown, OH .9418 Butler, OH 3240 Harrisburg-Lebanon-Carlisle, PA .9223 Cumberland, PA Dauphin, PA Lebanon, PA Perry, PA 3283 Hartford, CT 1.1549 Hartford, CT Litchfield, CT Middlesex, CT Tolland, CT 3285 Hattiesburg, MS .7659 Forrest, MS Lamar, MS 3290 Hickory-Morganton-Lenoir, NC .9028 Alexander, NC Burke, NC Caldwell, NC Catawaba, NC 3320 Honolulu, HI 1.1457 Honolulu, HI 3350 Houma, LA .8385 Lafourche, LA Terrebonne, LA 3360 Houston, TX .9892 Chambers, TX Fort Bend, TX Harris, TX Liberty, TX Montgomery, TX Waller, TX 3400 Huntington-Ashland, WV-KY-OH .9636 Boyd, KY Carter, KY Grenup, KY Lawrence, OH Cabell, WV Wayne, WV 3440 Huntsville, AL .8903 Limestone, AL Madison, AL 3480 Indianapolis, IN .9717 Boone, IN Hamilton, IN Hancoock, IN Hendricks, IN Johnson, IN Madison, IN Marion, IN Morgan, IN Shelby, IN 3500 Iowa City, IA .9587 Johnson, IA 3520 Jackson, MI .9532 Jackson, MI 3560 Jackson, MS .8607 Hinds, MS Madison, MS Rankin MS 3580 Jackson, TN .9275 Madison, TN Chester, TN 3600 Jacksonville, FL .9381 Clay, FL Duval, FL Nassau, FL St. Johns, FL 3605 Jacksonville, NC .8239 Onslow, NC 3610 Jamestown, NY .7976 Chautauqua, NY 3620 Janesville-Beloit, WI .9849 Rock, WI 3640 Jersey City, NJ 1.1190 Hudson, NJ 3660 Johnson City-Kingsport-Bristol, TN-VA .8268 Carter, TN Hawkins, TN Sullivan, TN Unicoi, TN Washington, TN Bristol City, VA Scott, VA Washington, VA 3680 Johnstown, PA .8329 Cambria, PA Somerset, PA 3700 Jonesboro, AR .7749 Craighead, AR 3710 Joplin, MO .8613 Jasper, MO Newton, MO 3720 Kalamazoo-Battlecreek, MI 1.0595 Calhoun, MI Kalamazoo, MI Van Buren, MI 3740 Kankakee, IL 1.0790 Kankakee, IL 3760 Kansas City, KS-MO .9736 Johnson, KS Leavenworth, KS Miami, KS Wyandotte, KS Cass, MO Clay, MO Clinton, MO Jackson, MO Lafayette, MO Platte, MO Ray, MO 3800 Kenosha, WI .9686 Kenosha, WI 3810 Killeen-Temple, TX 1.0399 Bell, TX Coryell, TX 3840 Knoxville, TN .8970 Anderson, TN Blount, TN Knox, TN Loudon, TN Sevier, TN Union, TN 3850 Kokomo, IN .8971 Howard, IN Tipton, IN 3870 La Crosse, WI-MN .9400 Houston, MN La Crosse, WI 3880 Lafayette, LA .8475 Acadia, LA Lafayette, LA St. Landry, LA St. Martin, LA 3920 Lafayette, IN .9278 Clinton, IN Tippecanoe, IN 3960 Lake Charles, LA .7965 Calcasieu, LA 3980 Lakeland-Winter Haven, FL .9357 Polk, FL 4000 Lancaster, PA .9078 Lancaster, PA 4040 Lansing-East Lansing, MI .9726 Clinton, MI Eaton, MI Ingham, MI 4080 Laredo, TX .8472 Webb, TX 4100 Las Cruces, NM .8745 Dona Ana, NM 4120 Las Vegas, NV-AZ 1.1521 Mohave, AZ Clark, NV Nye, NV 4150 Lawrence, KS .7983 Douglas, KS 4200 Lawton, OK .8315 Comanche, OK 4243 Lewiston-Auburn, ME .9179 Androscoggin, ME 4280 Lexington, KY .8581 Bourbon, KY Clark, KY Fayette, KY Jessamine, KY Madison, KY Scott, KY Woodford, KY Lima, OH .9483 4320 Allen, OH Auglaize, OH 4360 Lincoln, NE .9892 Lancaster, NE 4400 Little Rock-North Little Rock, AR .9097 Faulkner, AR Lonoke, AR Pulaski, AR Saline, AR 4420 Longview-Marshall, TX .8629 Gregg, TX Harrison, TX Upshur, TX 4480 Los Angeles-Long Beach, CA 1.2001 Los Angeles, CA 4520 Louisville, KY-IN .9276 Clark, IN Floyd, IN Harrison, IN Scott, IN Bullitt, KY Jefferson, KY Oldham, KY 4600 Lubbock, TX .9646 Lubbock, TX 4640 Lynchburg, VA .9219 Amherst, VA Bedford, VA Bedford City, VA Campbell, VA Lynchburg City, VA 4680 Macon, GA .9204 Bibb, GA Houston, GA Jones, GA Peach, GA Twiggs, GA 4720 Madison, WI 1.0467 Dane, WI 4800 Mansfield, OH .8900 Crawford, OH Richland, OH 4840 Mayaguez, PR .4914 Anasco, PR Cabo Rojo, PR Hormigueros, PR Mayaguez, PR Sabana Grande, PR San German, PR 4880 McAllen-Edinburg-Mission, TX .8428 Hidalgo, TX 4890 Medford-Ashland, OR 1.0498 Jackson, OR 4900 Melbourne-Titusville-Palm Bay, FL 1.0253 Brevard, FL 4920 Memphis, TN-AR-MS .8920 Crittenden, AR DeSoto, MS Fayette, TN Shelby, TN Tipton, TN 4940 Merced, CA .9837 Merced, CA 5000 Miami, FL .9802 Dade, FL 5015 Middlesex-Somerset-Hunterdon, NJ 1.1213 Hunterdon, NJ Middlesex, NJ Somerset, NJ 5080 Milwaukee-Waukesha, WI .9893 Milwaukee, WI Ozaukee, WID Washington, WI Waukesha, WI 5120 Minneapolis-St. Paul, MN-WI 1.0903 Anoka, MN Carver, MN Chisago, MN Dakota, MN Hennepin, MN Isanti, MN Ramsey, MN Scott, MN Sherburne, MN Washington, MN Wright, MN Pierce, WI St. Croix, WI 5140 Missoula, MT .9157 Missoula, MT 5160 Mobile, AL .8108 Baldwin, AL Mobile, AL 5170 Modesto, CA 1.0498 Stanislaus, CA 5190 Monmouth-Ocean, NJ 1.0674 Monmouth, NJ Ocean, NJ 5200 Monroe, LA .8137 Ouachita, LA 5240 Montgomery, AL .7734 Autauga, AL Elmore, AL Montgomery, AL 5280 Muncie, IN .9284 Delaware, IN 5330 Myrtle Beach, SC .8976 Horry, SC 5345 Naples, FL .9754 Collier, FL 5360 Nashville, TN .9578 Cheatham, TN Davidson, TN Dickson, TN Robertson, TN Rutherford, TN Sumner, TN Williamson, TN Wilson, TN 5380 Nassau-Suffolk, NY 1.3357 Nassau, NY Suffolk, NY 5483 New Haven-Bridgeport-Stamford-Waterbury-Danbury, CT 1.2408 Fairfield, CT New Haven, CT 5523 New London-Norwich, CT 1.1767 New London, CT 5560 New Orleans, LA .9046 Jefferson, LA Orleans, LA Plaquemines, LA St. Bernard, LA St. Charles, LA St. James, LA St. John The Baptist, LA St. Tammany, LA 5600 New York, NY 1.4414 Bronx, NY Kings, NY New York, NY Putnam, NY Queens, NY Richmond, NY Rockland, NY Westchester, NY 5640 Newark, NJ 1.1381 Essex, NJ Morris, NJ Sussex, NJ Union, NJ Warren, NJ 5660 Newburgh, NY—PA 1.1387 Orange, NY Pike, PA 5720 Norfolk-Virginia Beach-Newport News, VA-NC .8574 Currituck, NC Chesapeake City, VA Gloucester, VA Hampton City, VA Isle of Wight, VA James City, VA Mathews, VA Newport News City, VA Norfolk City, VA Poquoson City, VA Portsmouth City, VA Suffolk City, VA Virginia Beach City VA Williamsburg City, VA York, VA 5775 Oakland, CA 1.5072 Alameda, CA Contra Costa, CA 5790 Ocala, FL .9402 Marion, FL 5800 Odessa-Midland, TX .9397 Ector, TX Midland, TX 5880 Oklahoma City, OK .8900 Canadian, OK Cleveland, OK Logan, OK McClain, OK Oklahoma, OK Pottawatomie, OK 5910 Olympia, WA 1.0960 Thurston, WA 5920 Omaha, NE-IA .9978 Pottawattamie, IA Cass, NE Douglas, NE Sarpy, NE Washington, NE 5945 Orange County, CA 1.1474 Orange, CA 5960 Orlando, FL .9640 Lake, FL Orange, FL Osceola, FL Seminole, FL 5990 Owensboro, KY .8344 Daviess, KY 6015 Panama City, FL .8865 Bay, FL 6020 Parkersburg-Marietta, WV-OH .8127 Washington, OH Wood, WV 6080 Pensacola, FL .8645 Escambia, FL Santa Rosa, FL 6120 Peoria-Pekin, IL .8739 Peoria, IL Tazewell, IL Woodford, IL 6160 Philadelphia, PA-NJ 1.0713 Burlington, NJ Camden, NJ Gloucester, NJ Salem, NJ Bucks, PA Chester, PA Delaware, PA Mongtomery, PA Philadelphia, PA 6200 Phoenix-Mesa, AZ .9820 Maricopa, AZ Pinal, AZ 6240 Pine Bluff, AR .7962 Jefferson, AR 6280 Pittsburgh, PA .9365 Allegheny, PA Beaver, PA Butler, PA Fayette, PA Washington, PA Westmoreland, PA 6323 Pittsfield, MA 1.0235 Berkshire, MA 6340 Pocatello, ID .9372 Bannock, ID 6360 Ponce, PR .5169 Guayanilla, PR Juana Diaz, PR Penuelas, PR Ponce, PR Villalba, PR Yauco, PR 6403 Portland, ME .9794 Cumberland, ME Sagadahoc, ME York, ME 6440 Portland-Vancouver, OR-WA 1.0667 Clackamas, OR Columbia, OR Multnomah, OR Washington, OR Yamhill, OR Clark, WA 6483 Providence-Warwick-Pawtucket, RI 1.0854 Bristol, RI Kent, RI Newport, RI Providence, RI Washington, RI 6520 Provo-Orem, UT .9984 Utah, UT 6560 Pueblo, CO .8820 Pueblo, CO 6580 Punta Gorda, FL .9218 Charlotte, FL 6600 Racine, WI .9334 Racine, WI 6640 Raleigh-Durham-Chapel Hill, NC .9990 Chatham, NC Durham, NC Franklin, NC Johnston, NC Orange, NC Wake, NC 6660 Rapid City, SD .8846 Pennington, SD 6680 Reading, PA .9295 Berks, PA 6690 Redding, CA 1.1135 Shasta, CA 6720 Reno, NV 1.0648 Washoe, NV 6740 Richland-Kennewick-Pasco, WA 1.1491 Benton, WA Franklin, WA 6760 Richmond-Petersburg, VA .9477 Charles City County, VA Chesterfield, VA Colonia Heights City, VA Dinwiddie, VA Goochland, VA Hanover, VA Henrico, VA Hopewell City, VA New Kent, VA Petersburg City, VA Powhatan, VA Prince George, VA Richmond City, VA 6780 Riverside-San Bernardino, CA 1.1365 Riverside, CA San Bernardino, CA 6800 Roanoke, VA .8614 Botetourt, VA Roanoke, VA Roanoke City, VA Salem City, VA 6820 Rochester, MN 1.2139 Olmsted, MN 6840 Rochester, NY .9194 Genesee, NY Livingston, NY Monroe, NY Ontario, NY Orleans, NY Wayne, NY 6880 Rockford, IL .9625 Boone, IL Ogle, IL Winnebago, IL 6895 Rocky Mount, NC .9228 Edgecombe, NC Nash, NC 6920 Sacramento, CA 1.1500 El Dorado, CA Placer, CA Sacramento, CA 6960 Saginaw-Bay City-Midland, MI .9650 Bay, MI Midland, MI Saginaw, MI 6980 St. Cloud, MN .9700 Benton, MN Stearns, MN 7000 St. Joseph, MO .8021 Andrew, MO Buchanan, MO 7040 St. Louis, MO-IL .8855 Clinton, IL Jersey, IL Madison, IL Monroe, IL St. Clair, IL Franklin, MO Jefferson, MO Lincoln, MO St. Charles, MO St. Louis, MO St. Louis City, MO Warren, MO 7080 Salem, OR 1.0367 Marion, OR Polk, OR 7120 Salinas, CA 1.4623 Monterey, CA 7160 Salt Lake City-Ogden, UT .9945 Davis, UT Salt Lake, UT Weber, UT 7200 San Angelo, TX .8374 Tom Green, TX 7240 San Antonio, TX .8753 Bexar, TX Comal, TX Guadalupe, TX Wilson, TX 7320 San Diego, CA 1.1131 San Diego, CA 7360 San Francisco, CA 1.4142 Marin, CA San Francisco, CA San Mateo, CA 7400 San Jose, CA 1.4145 Santa Clara, CA 7440 San Juan-Bayamon, PR .4741 Aguas Buenas, PR Barceloneta, PR Bayamon, PR Canovanas, PR Carolina, PR Catano, PR Ceiba, PR Comerio, PR Corozal, PR Dorado, PR Fajardo, PR Florida, PR Guaynabo, PR Humacao, PR Juncos, PR Los Piedras, PR Loiza, PR Luguillo, PR Manati, PR Morovis, PR Naguabo, PR Naranjito, PR Rio Grande, PR San Juan, PR Toa Alta, PR Toa Baja, PR Trujillo Alto, PR Vega Alta, PR Vega Baja, PR Yabucoa, PR 7460 San Luis Obispo-Atascadero-Paso 1.1271 Robles, CA San Luis Obispo, CA 7480 Santa Barbara-Santa Maria-Lompoc, CA 1.0481 Santa Barbara, CA 7485 Santa Cruz-Watsonville, CA 1.3646 Santa Cruz, CA 7490 Santa Fe, NM 1.0712 Los Alamos, NM Santa Fe, NM 7500 Santa Rosa, CA 1.3046 Sonoma, CA 7510 Sarasota-Bradenton, FL .9425 Manatee, FL Sarasota, FL 7520 Savannah, GA .9376 Bryan, GA Chatham, GA Effingham, GA 7560 Scranton-Wilkes-Barre-Hazleton, PA .8599 Columbia, PA Lackawanna, PA Luzerne, PA Wyoming, PA 7600 Seattle-Bellevue-Everett, WA 1.1474 Island, WA King, WA Snohomish, WA 7610 Sharon, PA .7869 Mercer, PA 7620 Sheboygan, WI .8697 Sheboygan, WI 7640 Sherman-Denison, TX .9255 Grayson, TX 7680 Shreveport-Bossier City, LA .8987 Bossier, LA Caddo, LA Webster, LA 7720 Sioux City, IA-NE .9046 Woodbury, IA Dakota, NE 7760 Sioux Falls, SD .9257 Lincoln, SD Minnehaha, SD 7800 South Bend, IN .9802 St. Joseph, IN 7840 Spokane, WA 1.0852 Spokane, WA 7880 Springfield, IL .8659 Menard, IL Sangamon, IL 7920 Springfield, MO .8424 Christian, MO Greene, MO Webster, MO 8003 Springfield, MA 1.0927 Hampden, MA Hampshire, MA 8050 State College, PA .8941 Centre, PA 8080 Steubenville-Weirton, OH-WV .8804 Jefferson, OH Brooke, WV Hancock, WV 8120 Stockton-Lodi, CA 1.0506 San Joaquin, CA 8140 Sumter, SC .8273 Sumter, SC 8160 Syracuse, NY .9714 Cayuga, NY Madison, NY Onondaga, NY Oswego, NY 8200 Tacoma, WA 1.0940 Pierce, WA 8240 Tallahassee, FL .8504 Gadsden, FL Leon, FL 8280 Tampa-St. Petersburg-Clearwater, FL .9065 Hernando, FL Hillsborough, FL Pasco, FL Pinellas, FL 8320 Terre Haute, IN .8599 Clay, IN Vermillion, IN Vigo, IN 8360 Texarkana, AR-Texarkana, TX .8088 Miller, AR Bowie, TX 8400 Toledo, OH .9810 Fulton, OH Lucas, OH Wood, OH 8440 Topeka, KS .9199 Shawnee, KS 8480 Trenton, NJ 1.0432 Mercer, NJ 8520 Tucson, AZ .8911 Pima, AZ 8560 Tulsa, OK .8332 Creek, OK Osage, OK Rogers, OK Tulsa, OK Wagoner, OK 8600 Tuscaloosa, AL .8130 Tuscaloosa, AL 8640 Tyler, TX .9521 Smith, TX 8680 Utica-Rome, NY .8465 Herkimer, NY Oneida, NY 8720 Vallejo-Fairfield-Napa, CA 1.3354 Napa, CA Solano, CA 8735 Ventura, CA 1.1096 Ventura, CA 8750 Victoria, TX .8756 Victoria, TX 8760 Vineland-Millville-Bridgeton, NJ 1.0031 Cumberland, NJ 8780 Visalia-Tulare-Porterville, CA .9429 Tulare, CA 8800 Waco, TX .8073 McLennan, TX 8840 Washington, DC-MD-VA-WV 1.0851 District of Columbia, DC Calvert, MD Charles, MD Frederick, MD Montgomery, MD Prince Georges, MD Alexandria City, VA Arlington, VA Clarke, VA Culpeper, VA Fairfax, VA Fairfax City, VA Falls Church City, VA Fauquier, VA Fredericksburg City, VA King George, VA Loudoun, VA Manassas City, VA Manassas Park City, VA Prince William, VA Spotsylvania, VA Stafford, VA Warren, VA Berkeley, WV Jefferson, WV 8920 Waterloo-Cedar Falls, IA .8069 Black Hawk, IA 8940 Wausau, WI .9782 Marathon, WI 8960 West Palm Beach-Boca Raton, FL .9939 Palm Beach, FL 9000 Wheeling, WV-OH .7670 Belmont, OH Marshall, WV Ohio, WV 9040 Wichita, KS .9520 Butler, KS Harvey, KS Sedgwick, KS 9080 Wichita Falls, TX .8498 Archer, TX Wichita, TX 9140 Williamsport, PA .8544 Lycoming, PA 9160 Wilmington-Newark, DE-MD 1.1173 New Castle, DE Cecil, MD 9200 Wilmington, NC .9640 New Hanover, NC Brunswick, NC 9260 Yakima, WA 1.0569 Yakima, WA 9270 Yolo, CA .9434 Yolo, CA 9280 York, PA .9026 York, PA 9320 Youngstown-Warren, OH .9358 Columbiana, OH Mahoning, OH Trumbull, OH 9340 Yuba City, CA 1.0276 Sutter, CA Yuba, CA 9360 Yuma, AZ .8589 Yuma, AZ Addendum C.—Comparison of Pre-Floor and Pre-Reclassified Hospital Wage Index for FY 2002 and FY 2003 Rural area FY 2002 wage index FY 2003 wage index Percent change, FY 2002-FY 2003 ALABAMA 0.7339 0.766 4.37 ALASKA 1.1862 1.2293 3.63 ARIZONA 0.8681 0.8493 −2.17 ARKANSAS 0.7489 0.7666 2.36 CALIFORNIA 0.9659 0.984 1.87 COLORADO 0.8811 0.9015 2.32 CONNECTICUT 1.2077 1.2394 2.62 DELAWARE 0.9589 0.9128 −4.81 FLORIDA 0.8794 0.8814 0.23 GEORGIA 0.8295 0.823 −0.78 GUAM 0.9611 0.9611 0.00 HAWAII 1.1112 1.0255 −7.71 IDAHO 0.8718 0.8747 0.33 ILLINOIS 0.8053 0.8204 1.88 INDIANA 0.8721 0.8755 0.39 IOWA 0.8147 0.8315 2.06 KANSAS 0.7812 0.7923 1.42 KENTUCKY 0.7963 0.8079 1.46 LOUISIANA 0.7596 0.7567 −0.38 MAINE 0.8721 0.8874 1.75 MARYLAND 0.8859 0.8946 0.98 MASSACHUSETTS 1.1454 1.1288 −1.45 MICHIGAN 0.9 0.9 0.00 MINNESOTA 0.9035 0.9151 1.28 MISSISSIPPI 0.7528 0.768 2.02 MISSOURI 0.7891 0.8021 1.65 MONTANA 0.8655 0.8481 −2.01 NEBRASKA 0.8142 0.8204 0.76 NEVADA 0.9727 0.9577 −1.54 NEW HAMPSHIRE 0.9779 0.9796 0.17 NEW JERSEY NEW MEXICO 0.8676 0.8872 2.26 NEW YORK 0.8547 0.8542 −0.06 NORTH CAROLINA 0.8535 0.8666 1.53 Non-Urban area FY 2002 wage index FY 2003 wage index Percent change, FY 2002-FY 2003 (percent) NORTH DAKOTA 0.7879 0.7788 −1.15 OHIO 0.8668 0.8613 −0.63 OKLAHOMA 0.7566 0.759 0.32 OREGON 1.0027 1.0303 2.75 PENNSYLVANIA 0.8607 0.8462 −1.68 PUERTO RICO 0.48 0.4356 −9.25 RHODE ISLAND SOUTH CAROLINA 0.8512 0.8607 1.12 SOUTH DAKOTA 0.7861 0.7815 −0.59 TENNESSEE 0.7928 0.7877 −0.64 TEXAS 0.7712 0.7821 1.41 UTAH 0.9051 0.9312 2.88 VERMONT 0.9466 0.9345 −1.28 VIRGINIA 0.8241 0.8504 3.19 VIRGIN ISLANDS 0.6747 0.7845 16.27 WASHINGTON 1.0209 1.0179 −0.29 WEST VIRGINIA 0.8067 0.7975 −1.14 WISCONSIN 0.9066 0.9162 1.06 WYOMING 0.8747 0.9007 2.97 Urban MSA FY 2002 wage index FY 2003 wage index Percent change, FY 2002-FY 2003 0040 0.7965 0.7792 −2.17 0060 0.4683 0.4587 −2.05 0080 0.9876 0.96 −2.79 0120 1.064 1.0594 −0.43 0160 0.85 0.8384 −1.36 0200 0.9759 0.9315 −4.55 0220 0.8029 0.7859 −2.12 0240 1.0077 0.9735 −3.39 0280 0.9126 0.9225 1.08 0320 0.8711 0.9034 3.71 0380 1.257 1.2358 −1.69 0440 1.1098 1.1103 0.05 0450 0.8276 0.8044 −2.80 0460 0.9241 0.8997 −2.64 0470 0.463 0.4337 −6.33 0480 0.92 0.9876 7.35 0500 0.9842 1.0211 3.75 0520 1.0058 0.9991 −0.67 0560 1.1293 1.1017 −2.44 0580 0.823 0.8325 1.15 0600 0.997 1.0264 2.95 0640 0.963 0.9637 0.07 0680 0.9519 0.9899 3.99 0720 0.9856 0.9929 0.74 0733 0.9593 0.9664 0.74 0743 1.3626 1.3202 −3.11 0760 0.8149 0.8294 1.78 0840 0.8442 0.8324 −1.40 0860 1.1826 1.2282 3.86 0870 0.8887 0.9042 1.74 0875 1.1689 1.215 3.94 0880 0.9352 0.9022 −3.53 0920 0.844 0.8757 3.76 0960 0.8446 0.8341 −1.24 1000 0.8808 0.9222 4.70 1010 0.7984 0.7972 −0.15 1020 0.8842 0.8907 0.74 1040 0.9038 0.9109 0.79 1080 0.905 0.931 2.87 1123 1.1383 1.1235 −1.30 1125 0.9799 0.9689 −1.12 1145 0.8209 0.8535 3.97 1150 1.0758 1.0944 1.73 1240 0.9012 0.888 −1.46 1260 0.9328 0.8821 −5.44 1280 0.9459 0.9365 −0.99 1303 0.9883 1.0052 1.71 1310 0.4699 0.4371 −6.98 1320 0.8956 0.8932 −0.27 1350 0.9496 0.969 2.04 1360 0.8699 0.9056 4.10 1400 0.9306 1.0635 14.28 1440 0.9206 0.9235 0.32 1480 0.9264 0.8898 −3.95 1520 0.9336 0.985 5.51 1540 1.0566 1.0438 −1.21 1560 0.9369 0.8976 −4.19 1580 0.8288 0.8628 4.10 1600 1.1046 1.1044 −0.02 1620 0.9856 0.9745 −1.13 1640 0.9473 0.9381 −0.97 1660 0.8337 0.8406 0.83 1680 0.9457 0.967 2.25 1720 0.9744 0.9916 1.77 1740 0.8686 0.8496 −2.19 1760 0.9492 0.9307 −1.95 1800 0.844 0.8374 −0.78 1840 0.9565 0.9751 1.94 1880 0.8341 0.8729 4.65 1890 1.1646 1.1453 −1.66 1900 0.8306 0.7847 −5.53 1920 0.9936 0.9998 0.62 1950 0.8613 0.8859 2.86 1960 0.8638 0.8835 2.28 2000 0.9225 0.9282 0.62 2020 0.8972 0.9062 1.00 2030 0.8775 0.8973 2.26 2040 0.7987 0.8055 0.85 2080 1.0328 1.0601 2.64 2120 0.8779 0.8791 0.14 2160 1.0487 1.0448 −0.37 2180 0.7948 0.8137 2.38 2190 1.0296 0.9356 −9.13 2200 0.8519 0.8795 3.24 2240 1.0284 1.0368 0.82 2281 1.0532 1.0684 1.44 2290 0.8899 0.8952 0.60 2320 0.9215 0.9265 0.54 2330 0.9638 0.9722 0.87 2335 0.8415 0.8416 0.01 2340 0.8357 0.8376 0.23 2360 0.8716 0.8925 2.40 2400 1.1471 1.0944 −4.59 2440 0.8514 0.8177 −3.96 2520 0.9267 0.9684 4.50 2560 0.9027 0.8889 −1.53 2580 0.8445 0.81 −4.09 2620 1.0556 1.0682 1.19 2640 1.0913 1.1135 2.03 2650 0.7845 0.7792 −0.68 2655 0.8722 0.878 0.66 2670 1.0045 1.0066 0.21 2680 1.0293 1.0297 0.04 2700 0.9374 0.968 3.26 2710 1.0214 0.9823 −3.83 2720 0.8053 0.7895 −1.96 2750 0.9002 0.9693 7.68 2760 0.9203 0.9457 2.76 2800 0.9394 0.9446 0.55 2840 0.9984 1.0216 2.32 2880 0.8792 0.8505 −3.26 2900 0.9481 0.9871 4.11 2920 1.0313 0.9465 −8.22 2960 0.953 0.9584 0.57 2975 0.8336 0.8281 −0.66 2980 0.8709 0.8892 2.10 2985 0.9069 0.8897 −1.90 2995 0.9569 0.9456 −1.18 3000 1.0048 0.9525 −5.21 3040 0.887 0.895 0.90 3060 0.9495 0.9237 −2.72 3080 0.9208 0.9502 3.19 3120 0.9539 0.9282 −2.69 3150 0.9289 0.91 −2.03 3160 0.9217 0.9122 −1.03 3180 0.8365 0.9268 10.79 3200 0.9287 0.9418 1.41 3240 0.9425 0.9223 −2.14 3283 1.1533 1.1549 0.14 3285 0.7476 0.7659 2.45 3290 0.9367 0.9028 −3.62 3320 1.1539 1.1457 −0.71 3350 0.7975 0.8385 5.14 3360 0.9631 0.9892 2.71 3400 0.9616 0.9636 0.21 3440 0.8883 0.8903 0.23 3480 0.9698 0.9717 0.20 3500 0.9859 0.9587 −2.76 3520 0.9257 0.9532 2.97 3560 0.8491 0.8607 1.37 3580 0.9013 0.9275 2.91 3600 0.9223 0.9381 1.71 3605 0.7622 0.8239 8.09 3610 0.805 0.7976 −0.92 3620 0.9739 0.9849 1.13 3640 1.1178 1.119 0.11 3660 0.8617 0.8268 −4.05 3680 0.8723 0.8329 −4.52 3700 0.8425 0.7749 −8.02 3710 0.8727 0.8613 −1.31 3720 1.0639 1.0595 −0.41 3740 0.9889 1.079 9.11 3760 0.9536 0.9736 2.10 3800 0.9568 0.9686 1.23 3810 0.9764 1.0399 6.50 3840 0.889 0.897 0.90 3850 0.9126 0.8971 −1.70 3870 0.925 0.94 1.62 3880 0.8544 0.8475 −0.81 3920 0.9121 0.9278 1.72 3960 0.7765 0.7965 2.58 3980 0.9067 0.9357 3.20 4000 0.9296 0.9078 −2.35 4040 0.9653 0.9726 0.76 4080 0.7849 0.8472 7.94 4100 0.8621 0.8745 1.44 4120 1.1182 1.1521 3.03 4150 0.7812 0.7923 1.42 4200 0.8682 0.8315 −4.23 4243 0.9287 0.9179 −1.16 4280 0.8791 0.8581 −2.39 4320 0.947 0.9483 0.14 4360 1.0173 0.9892 −2.76 4400 0.8955 0.9097 1.59 4420 0.8571 0.8629 0.68 4480 1.1948 1.2001 0.44 4520 0.9529 0.9276 −2.66 4600 0.8449 0.9646 14.17 4640 0.9103 0.9219 1.27 4680 0.8957 0.9204 2.76 4720 1.0337 1.0467 1.26 4800 0.8708 0.89 2.20 4840 0.486 0.4914 1.11 4880 0.8378 0.8428 0.60 4890 1.0314 1.0498 1.78 4900 0.9913 1.0253 3.43 4920 0.8978 0.892 −0.65 4940 0.9947 0.9837 −1.11 5000 0.995 0.9802 −1.49 5015 1.1469 1.1213 −2.23 5080 0.9971 0.9893 −0.78 5120 1.093 1.0903 −0.25 5140 0.9364 0.9157 −2.21 5160 0.8082 0.8108 0.32 5170 1.082 1.0498 −2.98 5190 1.0851 1.0674 −1.63 5200 0.8201 0.8137 −0.78 5240 0.7359 0.7734 5.10 5280 0.9939 0.9284 −6.59 5330 0.8771 0.8976 2.34 5345 0.9699 0.9754 0.57 5360 0.9754 0.9578 −1.80 5380 1.3643 1.3357 −2.10 5483 1.2238 1.2408 1.39 5523 1.1526 1.1767 2.09 5560 0.9036 0.9046 0.11 5600 1.4427 1.4414 −0.09 5640 1.1622 1.1381 −2.07 5660 1.1113 1.1387 2.47 5720 0.8579 0.8574 −0.06 5775 1.5319 1.5072 −1.61 5790 0.9556 0.9402 −1.61 5800 1.0104 0.9397 −7.00 5880 0.8694 0.89 2.37 5910 1.135 1.096 −3.44 5920 0.9712 0.9978 2.74 5945 1.1123 1.1474 3.16 5960 0.9642 0.964 −0.02 5990 0.8334 0.8344 0.12 6015 0.9061 0.8865 −2.16 6020 0.8133 0.8127 −0.07 6080 0.8361 0.8645 3.40 6120 0.8773 0.8739 −0.39 6160 1.0947 1.0713 −2.14 6200 0.9638 0.982 1.89 6240 0.7895 0.7962 0.85 6280 0.956 0.9365 −2.04 6323 1.0278 1.0235 −0.42 6340 0.9448 0.9372 −0.80 6360 0.5218 0.5169 −0.94 6403 0.9427 0.9794 3.89 6440 1.1111 1.0667 −4.00 6483 1.0805 1.0854 0.45 6520 0.9843 0.9984 1.43 6560 0.8604 0.882 2.51 6580 0.9015 0.9218 2.25 6600 0.9333 0.9334 0.01 6640 0.9818 0.999 1.75 6660 0.8869 0.8846 −0.26 6680 0.9583 0.9295 −3.01 6690 1.1155 1.1135 −0.18 6720 1.0421 1.0648 2.18 6740 1.096 1.1491 4.84 6760 0.9678 0.9477 −2.08 6780 1.1112 1.1365 2.28 6800 0.8371 0.8614 2.90 6820 1.1462 1.2139 5.91 6840 0.9347 0.9194 −1.64 6880 0.9204 0.9625 4.57 6895 0.9109 0.9228 1.31 6920 1.1831 1.15 −2.80 6960 0.959 0.965 0.63 6980 0.9851 0.97 −1.53 7000 0.7891 0.8021 1.65 7040 0.8931 0.8855 −0.85 7080 1.0011 1.0367 3.56 7120 1.4684 1.4623 −0.42 7160 0.9863 0.9945 0.83 7200 0.8193 0.8374 2.21 7240 0.8584 0.8753 1.97 7320 1.1265 1.1131 −1.19 7360 1.414 1.4142 0.01 7400 1.4193 1.4145 −0.34 7440 0.4762 0.4741 −0.44 7460 1.099 1.1271 2.56 7480 1.0802 1.0481 −2.97 7485 1.397 1.3646 −2.32 7490 1.0194 1.0712 5.08 7500 1.3034 1.3046 0.09 7510 1.009 0.9425 −6.59 7520 1.0018 0.9376 −6.41 7560 0.8683 0.8599 −0.97 7600 1.1361 1.1474 0.99 7610 0.7926 0.7869 −0.72 7620 0.8427 0.8697 3.20 7640 0.9373 0.9255 −1.26 7680 0.905 0.8987 −0.70 7720 0.8767 0.9046 3.18 7760 0.9139 0.9257 1.29 7800 0.9993 0.9802 −1.91 7840 1.0668 1.0852 1.72 7880 0.8676 0.8659 −0.20 7920 0.8567 0.8424 −1.67 8003 1.0881 1.0927 0.42 8050 0.9133 0.8941 −2.10 8080 0.8637 0.8804 1.93 8120 1.0815 1.0506 −2.86 8140 0.7794 0.8273 6.15 8160 0.9621 0.9714 0.97 8200 1.1616 1.094 −5.82 8240 0.8527 0.8504 −0.27 8280 0.8925 0.9065 1.57 8320 0.8532 0.8599 0.79 8360 0.8327 0.8088 −2.87 8400 0.9809 0.981 0.01 8440 0.8912 0.9199 3.22 8480 1.0416 1.0432 0.15 8520 0.8967 0.8911 −0.62 8560 0.8902 0.8332 −6.40 8600 0.8171 0.813 −0.50 8640 0.9641 0.9521 −1.24 8680 0.8329 0.8465 1.63 8720 1.3562 1.3354 −1.53 8735 1.0994 1.1096 0.93 8750 0.8328 0.8756 5.14 8760 1.0441 1.0031 −3.93 8780 0.9628 0.9429 −2.07 8800 0.8129 0.8073 −0.69 8840 1.0962 1.0851 −1.01 8920 0.8041 0.8069 0.35 8940 0.9696 0.9782 0.89 8960 0.9777 0.9939 1.66 9000 0.7985 0.767 −3.94 9040 0.9606 0.952 −0.90 9080 0.7867 0.8498 8.02 9140 0.8628 0.8544 −0.97 9160 1.0877 1.1173 2.72 9200 0.9409 0.964 2.46 9260 1.0567 1.0569 0.02 9270 0.9701 0.9434 −2.75 9280 0.9441 0.9026 −4.40 9320 0.9563 0.9358 −2.14 9340 1.0359 1.0276 −0.80 9360 0.8989 0.8589 −4.45 [FR Doc. 03-16397 Filed 6-27-03; 8:45 am]

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