Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program; Correction

#  Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program; Correction

**AGENCY:**

Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services (HHS).

**ACTION:**

Proposed rule; correction.

**SUMMARY:**

This document corrects technical errors in the proposed rule that appeared in the February 11, 2026, *Federal Register* titled “Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program.”

**DATES:**

This correction is effective March 6, 2026.

**FOR FURTHER INFORMATION CONTACT:**

Jeff Wu, (301) 492-4305, Rogelyn McLean, (410) 786-1524, Grace Bristol, (410) 786-8437, for general information.

Ayesha Anwar, (301) 448-3625, or Joshua Paul, (301) 492-4347, for matters related to the HHS-operated risk adjustment and risk adjustment data validation (HHS-RADV) programs.

**SUPPLEMENTARY INFORMATION:**

**I. Background**

In FR Doc. 2026-02769 of February 11, 2026 (91 FR 6292), there were a number of technical errors that are identified and corrected in this correcting document.

**II. Summary of Errors**

On pages 6306 through 6319, we inadvertently omitted column headings in Tables 1 through 7.

**III. Correction of Errors**

In FR Doc. 2026-02769 of February 11, 2026 (91 FR 6292), make the following corrections:

1. On pages 6306 through 6312, the table titled “TABLE 1: Proposed Adult Risk Adjustment Model Factors for the 2027 Benefit Year” is corrected to read as follows:

| HCC or RXC No. | Factor | Platinum | Gold | Silver | Bronze | Catastrophic |
| --- | --- | --- | --- | --- | --- | --- |
|  |  |  |  |  |  |  |
|  | Age 21-24, Male | 0.189 | 0.135 | 0.097 | 0.068 | 0.060 |
|  | Age 25-29, Male | 0.201 | 0.142 | 0.100 | 0.067 | 0.059 |
|  | Age 30-34, Male | 0.231 | 0.166 | 0.118 | 0.080 | 0.070 |
|  | Age 35-39, Male | 0.252 | 0.183 | 0.130 | 0.088 | 0.076 |
|  | Age 40-44, Male | 0.280 | 0.206 | 0.149 | 0.101 | 0.088 |
|  | Age 45-49, Male | 0.322 | 0.244 | 0.183 | 0.132 | 0.118 |
|  | Age 50-54, Male | 0.371 | 0.286 | 0.219 | 0.163 | 0.147 |
|  | Age 55-59, Male | 0.413 | 0.322 | 0.250 | 0.188 | 0.171 |
|  | Age 60-64, Male | 0.467 | 0.366 | 0.286 | 0.216 | 0.198 |
|  | Age 21-24, Female | 0.278 | 0.196 | 0.132 | 0.082 | 0.067 |
|  | Age 25-29, Female | 0.311 | 0.221 | 0.149 | 0.091 | 0.074 |
|  | Age 30-34, Female | 0.384 | 0.288 | 0.209 | 0.144 | 0.126 |
|  | Age 35-39, Female | 0.435 | 0.335 | 0.253 | 0.184 | 0.166 |
|  | Age 40-44, Female | 0.484 | 0.379 | 0.292 | 0.216 | 0.195 |
|  | Age 45-49, Female | 0.491 | 0.385 | 0.293 | 0.214 | 0.192 |
|  | Age 50-54, Female | 0.506 | 0.397 | 0.302 | 0.219 | 0.197 |
|  | Age 55-59, Female | 0.467 | 0.358 | 0.265 | 0.184 | 0.162 |
|  | Age 60-64, Female | 0.467 | 0.355 | 0.260 | 0.177 | 0.154 |
|  |  |  |  |  |  |  |
| HCC001 | HIV/AIDS | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 |
| HCC002 | Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock | 8.520 | 8.314 | 8.233 | 8.129 | 8.123 |
| HCC003 | Central Nervous System Infections, Except Viral Meningitis | 7.760 | 7.653 | 7.601 | 7.527 | 7.511 |
| HCC004 | Viral or Unspecified Meningitis | 6.855 | 6.746 | 6.678 | 6.590 | 6.569 |
| HCC006 | Opportunistic Infections | 8.110 | 8.053 | 7.995 | 7.916 | 7.892 |
| HCC008 | Metastatic Cancer | 22.129 | 21.703 | 21.654 | 21.525 | 21.533 |
| HCC009 | Lung, Brain, and Other Severe Cancers, Including Pediatric Acute Lymphoid Leukemia | 12.286 | 11.994 | 11.925 | 11.798 | 11.789 |
| HCC010 | Non-Hodgkin Lymphomas and Other Cancers and Tumors | 5.400 | 5.216 | 5.126 | 5.002 | 4.980 |
| HCC011 | Colorectal, Breast (Age <50), Kidney, and Other Cancers | 3.851 | 3.657 | 3.554 | 3.419 | 3.396 |
| HCC012 | Breast (Age 50+) and Prostate Cancer, Benign/Uncertain Brain Tumors, and Other Cancers and Tumors | 2.465 | 2.326 | 2.237 | 2.127 | 2.105 |
| HCC013 | Thyroid Cancer, Melanoma, Neurofibromatosis, and Other Cancers and Tumors | 1.025 | 0.930 | 0.825 | 0.710 | 0.681 |
| HCC018 | Pancreas Transplant Status | 5.506 | 5.552 | 5.642 | 5.734 | 5.757 |
| HCC019 | Diabetes with Acute Complications | 0.189 | 0.145 | 0.102 | 0.060 | 0.050 |
| HCC020 | Diabetes with Chronic Complications | 0.189 | 0.145 | 0.102 | 0.060 | 0.050 |
| HCC021 | Diabetes without Complication | 0.189 | 0.145 | 0.102 | 0.060 | 0.050 |
| HCC022 | Type 1 Diabetes Mellitus, add-on to Diabetes HCCs 19-21 | 0.179 | 0.155 | 0.111 | 0.045 | 0.023 |
| HCC023 | Protein-Calorie Malnutrition | 10.099 | 9.974 | 9.925 | 9.854 | 9.843 |
| HCC026 | Mucopolysaccharidosis | 18.785 | 18.604 | 18.567 | 18.498 | 18.495 |
| HCC027 | Lipidoses and Glycogenosis | 18.785 | 18.604 | 18.567 | 18.498 | 18.495 |
| HCC029 | Amyloidosis, Porphyria, and Other Metabolic Disorders | 5.455 | 5.353 | 5.299 | 5.229 | 5.216 |
| HCC030 | Adrenal, Pituitary, and Other Significant Endocrine Disorders | 1.291 | 1.216 | 1.150 | 1.071 | 1.053 |
| HCC034 | Liver Transplant Status/Complications | 5.506 | 5.552 | 5.642 | 5.734 | 5.757 |
| HCC035_1 | Acute Liver Failure/Disease, Including Neonatal Hepatitis | 6.880 | 6.693 | 6.630 | 6.548 | 6.543 |
| HCC035_2 | Chronic Liver Failure/End-Stage Liver Disorders | 2.234 | 2.070 | 2.000 | 1.906 | 1.896 |
| HCC036 | Cirrhosis of Liver | 0.616 | 0.537 | 0.476 | 0.401 | 0.387 |
| HCC037_1 | Chronic Viral Hepatitis C | 0.516 | 0.455 | 0.396 | 0.336 | 0.325 |
| HCC037_2 | Chronic Hepatitis, Except Chronic Viral Hepatitis C | 0.516 | 0.455 | 0.396 | 0.336 | 0.325 |
| HCC041 | Intestine Transplant Status/Complications | 5.506 | 5.552 | 5.642 | 5.734 | 5.757 |
| HCC042 | Peritonitis/Gastrointestinal Perforation/Necrotizing Enterocolitis | 10.409 | 10.234 | 10.209 | 10.146 | 10.144 |
| HCC045 | Intestinal Obstruction | 4.795 | 4.594 | 4.499 | 4.369 | 4.350 |
| HCC046 | Chronic Pancreatitis | 2.131 | 1.971 | 1.875 | 1.755 | 1.738 |
| HCC047 | Acute Pancreatitis | 2.131 | 1.971 | 1.875 | 1.755 | 1.738 |
| HCC048 | Inflammatory Bowel Disease | 3.007 | 2.889 | 2.788 | 2.652 | 2.614 |
| HCC054 | Necrotizing Fasciitis | 6.731 | 6.567 | 6.536 | 6.475 | 6.470 |
| HCC055 | Bone/Joint/Muscle Infections/Necrosis | 4.138 | 3.961 | 3.912 | 3.843 | 3.843 |
| HCC056 | Rheumatoid Arthritis and Specified Autoimmune Disorders | 1.363 | 1.259 | 1.188 | 1.104 | 1.086 |
| HCC057 | Systemic Lupus Erythematosus and Other Autoimmune Disorders | 0.355 | 0.286 | 0.198 | 0.098 | 0.069 |
| HCC061 | Osteogenesis Imperfecta and Other Osteodystrophies | 1.753 | 1.635 | 1.546 | 1.437 | 1.415 |
| HCC062 | Congenital/Developmental Skeletal and Connective Tissue Disorders | 1.753 | 1.635 | 1.546 | 1.437 | 1.415 |
| HCC063 | Cleft Lip/Cleft Palate | 0.823 | 0.732 | 0.640 | 0.542 | 0.520 |
| HCC066 | Hemophilia | 70.952 | 70.627 | 70.590 | 70.491 | 70.495 |
| HCC067 | Myelodysplastic Syndromes and Myelofibrosis | 9.888 | 9.761 | 9.718 | 9.648 | 9.639 |
| HCC068 | Aplastic Anemia | 9.888 | 9.761 | 9.718 | 9.648 | 9.639 |
| HCC069 | Acquired Hemolytic Anemia, Including Hemolytic Disease of Newborn | 9.888 | 9.761 | 9.718 | 9.648 | 9.639 |
| HCC070 | Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero | 1.833 | 1.725 | 1.635 | 1.537 | 1.518 |
| HCC071 | Sickle-Cell Disorders, Except Sickle-Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major | 1.457 | 1.397 | 1.348 | 1.292 | 1.279 |
| HCC073 | Combined and Other Severe Immunodeficiencies | 4.364 | 4.272 | 4.239 | 4.184 | 4.176 |
| HCC074 | Disorders of the Immune Mechanism | 4.364 | 4.272 | 4.239 | 4.184 | 4.176 |
| HCC075 | Coagulation Defects and Other Specified Hematological Disorders | 2.167 | 2.085 | 2.024 | 1.948 | 1.930 |
| HCC081 | Drug Use with Psychotic Complications | 1.479 | 1.349 | 1.232 | 1.092 | 1.059 |
| HCC082 | Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications | 1.479 | 1.349 | 1.232 | 1.092 | 1.059 |
| HCC083 | Alcohol Use with Psychotic Complications | 0.857 | 0.746 | 0.647 | 0.533 | 0.507 |
| HCC084 | Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications | 0.857 | 0.746 | 0.647 | 0.533 | 0.507 |
| HCC087_1 | Schizophrenia | 2.215 | 2.050 | 1.928 | 1.784 | 1.757 |
| HCC087_2 | Delusional and Other Specified Psychotic Disorders, Unspecified Psychosis | 2.087 | 1.932 | 1.803 | 1.645 | 1.611 |
| HCC088 | Major Depressive Disorder, Severe, and Bipolar Disorders | 0.927 | 0.831 | 0.728 | 0.609 | 0.578 |
| HCC090 | Personality Disorders | 0.666 | 0.587 | 0.487 | 0.377 | 0.343 |
| HCC094 | Anorexia/Bulimia Nervosa | 1.855 | 1.749 | 1.663 | 1.555 | 1.529 |
| HCC096 | Prader-Willi, Patau, Edwards, and Autosomal Deletion Syndromes | 9.243 | 9.207 | 9.184 | 9.155 | 9.144 |
| HCC097 | Down Syndrome, Fragile X, Other Chromosomal Anomalies, and Congenital Malformation Syndromes | 0.779 | 0.715 | 0.659 | 0.596 | 0.581 |
| HCC102 | Autistic Disorder | 0.670 | 0.590 | 0.496 | 0.397 | 0.367 |
| HCC103 | Pervasive Developmental Disorders, Except Autistic Disorder | 0.666 | 0.587 | 0.487 | 0.377 | 0.343 |
| HCC106 | Traumatic Complete Lesion Cervical Spinal Cord | 9.567 | 9.405 | 9.331 | 9.227 | 9.211 |
| HCC107 | Quadriplegia | 9.567 | 9.405 | 9.331 | 9.227 | 9.211 |
| HCC108 | Traumatic Complete Lesion Dorsal Spinal Cord | 6.337 | 6.186 | 6.106 | 5.994 | 5.975 |
| HCC109 | Paraplegia | 6.337 | 6.186 | 6.106 | 5.994 | 5.975 |
| HCC110 | Spinal Cord Disorders/Injuries | 4.665 | 4.482 | 4.406 | 4.296 | 4.280 |
| HCC111 | Amyotrophic Lateral Sclerosis and Other Anterior Horn Cell Disease | 6.067 | 5.909 | 5.822 | 5.707 | 5.686 |
| HCC112 | Quadriplegic Cerebral Palsy | 0.975 | 0.868 | 0.773 | 0.658 | 0.631 |
| HCC113 | Cerebral Palsy, Except Quadriplegic | 0.426 | 0.363 | 0.300 | 0.229 | 0.210 |
| HCC114 | Spina Bifida and Other Brain/Spinal/Nervous System Congenital Anomalies | 1.116 | 1.035 | 0.959 | 0.864 | 0.841 |
| HCC115 | Myasthenia Gravis/Myoneural Disorders and Guillain-Barre Syndrome/Inflammatory and Toxic Neuropathy | 4.927 | 4.844 | 4.822 | 4.783 | 4.779 |
| HCC117 | Muscular Dystrophy | 1.362 | 1.272 | 1.191 | 1.094 | 1.070 |
| HCC118 | Multiple Sclerosis | 2.461 | 2.331 | 2.253 | 2.151 | 2.131 |
| HCC119 | Parkinson's, Huntington's, and Spinocerebellar Disease, and Other Neurodegenerative Disorders | 1.362 | 1.272 | 1.191 | 1.094 | 1.070 |
| HCC120 | Seizure Disorders and Convulsions | 0.929 | 0.840 | 0.758 | 0.660 | 0.637 |
| HCC121 | Hydrocephalus | 8.919 | 8.823 | 8.773 | 8.704 | 8.689 |
| HCC122 | Nontraumatic Coma, Except Diabetic, Hepatic, or Hypoglycemic; Nontraumatic Brain Compression/Anoxic Damage | 9.620 | 9.477 | 9.417 | 9.325 | 9.307 |
| HCC123 | Narcolepsy and Cataplexy | 4.303 | 4.171 | 4.101 | 4.006 | 3.987 |
| HCC125 | Respirator Dependence/Tracheostomy Status | 20.117 | 19.902 | 19.845 | 19.752 | 19.744 |
| HCC126 | Respiratory Arrest | 7.858 | 7.659 | 7.579 | 7.478 | 7.472 |
| HCC127 | Cardio-Respiratory Failure and Shock, Including Respiratory Distress Syndromes | 7.858 | 7.659 | 7.579 | 7.478 | 7.472 |
| HCC128 | Heart Assistive Device/Artificial Heart | 14.408 | 14.322 | 14.312 | 14.307 | 14.304 |
| HCC129 | Heart Transplant Status/Complications | 14.408 | 14.322 | 14.312 | 14.307 | 14.304 |
| HCC130 | Heart Failure | 1.628 | 1.543 | 1.490 | 1.421 | 1.407 |
| HCC131 | Acute Myocardial Infarction | 4.410 | 4.188 | 4.129 | 4.044 | 4.047 |
| HCC132 | Unstable Angina and Other Acute Ischemic Heart Disease | 3.261 | 3.073 | 2.986 | 2.868 | 2.856 |
| HCC135 | Heart Infection/Inflammation, Except Rheumatic | 7.943 | 7.850 | 7.792 | 7.709 | 7.689 |
| HCC137 | Hypoplastic Left Heart Syndrome and Other Severe Congenital Heart Disorders | 2.004 | 1.911 | 1.843 | 1.763 | 1.745 |
| HCC138 | Major Congenital Heart/Circulatory Disorders | 2.004 | 1.911 | 1.843 | 1.763 | 1.745 |
| HCC139 | Atrial and Ventricular Septal Defects, Patent Ductus Arteriosus, and Other Congenital Heart/Circulatory Disorders | 2.004 | 1.911 | 1.843 | 1.763 | 1.745 |
| HCC142 | Specified Heart Arrhythmias | 1.831 | 1.725 | 1.640 | 1.531 | 1.501 |
| HCC145 | Intracranial Hemorrhage | 9.782 | 9.608 | 9.545 | 9.452 | 9.441 |
| HCC146 | Ischemic or Unspecified Stroke | 1.438 | 1.326 | 1.258 | 1.173 | 1.161 |
| HCC149 | Cerebral Aneurysm and Arteriovenous Malformation | 1.977 | 1.859 | 1.772 | 1.659 | 1.634 |
| HCC150 | Hemiplegia/Hemiparesis | 2.618 | 2.497 | 2.459 | 2.405 | 2.403 |
| HCC151 | Monoplegia, Other Paralytic Syndromes | 2.198 | 2.088 | 2.019 | 1.931 | 1.916 |
| HCC153 | Atherosclerosis of the Extremities with Ulceration or Gangrene | 7.585 | 7.409 | 7.407 | 7.376 | 7.389 |
| HCC154 | Vascular Disease with Complications | 4.906 | 4.756 | 4.694 | 4.605 | 4.591 |
| HCC156 | Pulmonary Embolism and Deep Vein Thrombosis | 7.104 | 7.018 | 6.942 | 6.837 | 6.805 |
| HCC158 | Lung Transplant Status/Complications | 11.333 | 11.261 | 11.238 | 11.227 | 11.221 |
| HCC159 | Cystic Fibrosis | 2.992 | 2.873 | 2.799 | 2.714 | 2.700 |
| HCC160 | Chronic Obstructive Pulmonary Disease, Including Bronchiectasis | 0.615 | 0.539 | 0.454 | 0.360 | 0.334 |
| HCC161_1 | Severe Asthma | 0.615 | 0.539 | 0.454 | 0.360 | 0.334 |
| HCC161_2 | Asthma, Except Severe | 0.615 | 0.539 | 0.454 | 0.360 | 0.334 |
| HCC162 | Fibrosis of Lung and Other Lung Disorders | 1.305 | 1.231 | 1.161 | 1.075 | 1.052 |
| HCC163 | Aspiration and Specified Bacterial Pneumonias and Other Severe Lung Infections | 6.880 | 6.765 | 6.706 | 6.629 | 6.616 |
| HCC174 | Exudative Macular Degeneration | 1.231 | 1.115 | 0.988 | 0.838 | 0.804 |
| HCC183 | Kidney Transplant Status/Complications | 5.506 | 5.552 | 5.642 | 5.734 | 5.757 |
| HCC184 | End Stage Renal Disease | 17.965 | 17.541 | 17.668 | 17.485 | 17.544 |
| HCC187 | Chronic Kidney Disease, Stage 5 | 0.749 | 0.679 | 0.661 | 0.621 | 0.622 |
| HCC188 | Chronic Kidney Disease, Severe (Stage 4) | 0.749 | 0.679 | 0.661 | 0.621 | 0.622 |
| HCC203 | Ectopic and Molar Pregnancy | 1.438 | 1.302 | 1.131 | 0.927 | 0.875 |
| HCC204 | Miscarriage with Complications | 0.638 | 0.554 | 0.420 | 0.253 | 0.193 |
| HCC205 | Miscarriage with No or Minor Complications | 0.638 | 0.554 | 0.420 | 0.253 | 0.193 |
| HCC207 | Pregnancy with Delivery with Major Complications | 3.610 | 3.349 | 3.031 | 2.654 | 2.581 |
| HCC208 | Pregnancy with Delivery with Complications | 3.610 | 3.349 | 3.031 | 2.654 | 2.581 |
| HCC209 | Pregnancy with Delivery with No or Minor Complications | 2.645 | 2.446 | 2.126 | 1.713 | 1.597 |
| HCC210 | (Ongoing) Pregnancy without Delivery with Major Complications | 0.668 | 0.572 | 0.416 | 0.240 | 0.186 |
| HCC211 | (Ongoing) Pregnancy without Delivery with Complications | 0.494 | 0.412 | 0.283 | 0.148 | 0.106 |
| HCC212 | (Ongoing) Pregnancy without Delivery with No or Minor Complications | 0.023 | 0.000 | 0.000 | 0.000 | 0.000 |
| HCC217 | Chronic Ulcer of Skin, Except Pressure | 1.351 | 1.259 | 1.205 | 1.140 | 1.131 |
| HCC218 | Extensive Third Degree Burns | 28.529 | 28.296 | 28.253 | 28.168 | 28.162 |
| HCC219 | Major Skin Burn or Condition | 2.661 | 2.532 | 2.452 | 2.356 | 2.337 |
| HCC223 | Severe Head Injury | 16.085 | 15.926 | 15.853 | 15.744 | 15.724 |
| HCC226 | Hip and Pelvic Fractures | 7.742 | 7.485 | 7.431 | 7.338 | 7.340 |
| HCC228 | Vertebral Fractures without Spinal Cord Injury | 4.007 | 3.844 | 3.742 | 3.608 | 3.582 |
| HCC234 | Traumatic Amputations and Amputation Complications | 4.272 | 4.112 | 4.068 | 3.998 | 3.995 |
| HCC251 | Stem Cell, Including Bone Marrow, Transplant Status/Complications | 17.990 | 18.025 | 18.043 | 18.074 | 18.067 |
| HCC253 | Artificial Openings for Feeding or Elimination | 5.400 | 5.276 | 5.237 | 5.177 | 5.172 |
| HCC254 | Amputation Status, Upper Limb or Lower Limb | 0.923 | 0.828 | 0.775 | 0.708 | 0.699 |
|  |  |  |  |  |  |  |
|  | Severe illness, 1 payment HCC | −5.506 | −5.552 | −5.642 | −5.734 | −5.757 |
|  | Severe illness, 2 payment HCCs | −5.381 | −5.451 | −5.529 | −5.615 | −5.630 |
|  | Severe illness, 3 payment HCCs | −4.624 | −4.683 | −4.671 | −4.664 | −4.645 |
|  | Severe illness, 4 payment HCCs | −4.046 | −4.060 | −3.933 | −3.798 | −3.740 |
|  | Severe illness, 5 payment HCCs | −3.634 | −3.590 | −3.359 | −3.113 | −3.027 |
|  | Severe illness, 6 payment HCCs | −3.188 | −3.063 | −2.734 | −2.385 | −2.275 |
|  | Severe illness, 7 payment HCCs | −2.710 | −2.475 | −2.060 | −1.614 | −1.485 |
|  | Severe illness, 8 payment HCCs | −2.359 | −2.047 | −1.553 | −1.014 | -0.870 |
|  | Severe illness, 9 payment HCCs | −0.965 | −0.515 | 0.053 | 0.682 | 0.839 |
|  | Severe illness, 10 or more payment HCCs | 4.976 | 5.806 | 6.546 | 7.415 | 7.608 |
|  | Transplant severe illness, 4 payment HCCs | 3.531 | 3.394 | 3.262 | 3.071 | 3.034 |
|  | Transplant severe illness, 5 payment HCCs | 6.812 | 6.664 | 6.540 | 6.354 | 6.326 |
|  | Transplant severe illness, 6 payment HCCs | 10.112 | 9.960 | 9.839 | 9.656 | 9.631 |
|  | Transplant severe illness, 7 payment HCCs | 15.321 | 15.165 | 15.051 | 14.879 | 14.859 |
|  | Transplant severe illness, 8 or more payment HCCs | 29.664 | 29.601 | 29.511 | 29.375 | 29.357 |
|  |  |  |  |  |  |  |
|  | Enrolled for 1 month, at least one payment HCC | 11.074 | 9.697 | 8.663 | 7.661 | 7.414 |
|  | Enrolled for 2 months, at least one payment HCC | 4.976 | 4.271 | 3.729 | 3.226 | 3.102 |
|  | Enrolled for 3 months, at least one payment HCC | 3.206 | 2.743 | 2.369 | 2.026 | 1.944 |
|  | Enrolled for 4 months, at least one payment HCC | 1.883 | 1.566 | 1.297 | 1.054 | 0.995 |
|  | Enrolled for 5 months, at least one payment HCC | 1.400 | 1.164 | 0.955 | 0.763 | 0.714 |
|  | Enrolled for 6 months, at least one payment HCC | 0.936 | 0.762 | 0.599 | 0.448 | 0.407 |
|  |  |  |  |  |  |  |
| ACF01 | HIV Pre-Exposure Prophylaxis (PrEP) | 3.620 | 3.551 | 3.472 | 3.304 | 3.258 |
|  |  |  |  |  |  |  |
| RXC01 | Anti-HIV Agents | 4.595 | 4.125 | 3.714 | 3.356 | 3.280 |
| RXC02 | Anti-Hepatitis C (HCV) Agents, Direct Acting Agents | 9.107 | 8.614 | 8.476 | 8.335 | 8.361 |
| RXC03 | Antiarrhythmics | 0.058 | 0.052 | 0.046 | 0.039 | 0.046 |
| RXC04 | Phosphate Binders | 0.868 | 0.993 | 0.785 | 0.988 | 0.917 |
| RXC05 | Inflammatory Bowel Disease Agents | 1.133 | 1.100 | 1.040 | 0.981 | 0.962 |
| RXC06 | Insulin | 1.313 | 1.147 | 0.991 | 0.843 | 0.805 |
| RXC07 | Anti-Diabetic Agents, Except Insulin and Metformin Only | 0.973 | 0.862 | 0.698 | 0.485 | 0.419 |
| RXC08 | Multiple Sclerosis Agents | 12.472 | 11.759 | 11.490 | 11.110 | 11.042 |
| RXC09 | Immune Suppressants and Immunomodulators | 11.545 | 10.994 | 10.921 | 10.759 | 10.777 |
| RXC10 | Cystic Fibrosis Agents | 22.801 | 22.295 | 22.221 | 22.083 | 22.098 |
| RXC01 x HCC001 | Additional effect for enrollees with RXC 01 and HCC 001 | 2.629 | 2.556 | 2.848 | 3.009 | 3.091 |
| RXC02 x HCC037_1, 036, 035_2, 035_1, 034 | Additional effect for enrollees with RXC 02 and (HCC 037_1 or 036 or 035_2 or 035_1 or 034) | -0.516 | -0.455 | -0.396 | -0.336 | -0.325 |
| RXC03 x HCC142 | Additional effect for enrollees with RXC 03 and HCC 142 | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 |
| RXC04 x HCC184, 183, 187, 188 | Additional effect for enrollees with RXC 04 and (HCC 184 or 183 or 187 or 188) | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 |
| RXC05 x HCC048, 041 | Additional effect for enrollees with RXC 05 and (HCC 048 or 041) | −1.106 | −1.087 | −1.040 | −0.981 | −0.962 |
| RXC06 x HCC018, 019, 020, 021 | Additional effect for enrollees with RXC 06 and (HCC 018 or 019 or 020 or 021) | 0.466 | 0.511 | 0.522 | 0.482 | 0.474 |
| RXC07 x HCC018, 019, 020, 021 | Additional effect for enrollees with RXC 07 and (HCC 018 or 019 or 020 or 021) | −0.187 | −0.143 | −0.102 | −0.060 | −0.050 |
| RXC08 x HCC118 | Additional effect for enrollees with RXC 08 and HCC 118 | −0.156 | 0.110 | 0.411 | 0.745 | 0.854 |
| RXC09 x HCC056 or 057 and 048 or 041 | Additional effect for enrollees with RXC 09 and (HCC 048 or 041) and (HCC 056 or 057) | 0.492 | 0.557 | 0.646 | 0.751 | 0.780 |
| RXC09 x HCC056 | Additional effect for enrollees with RXC 09 and HCC 056 | −1.363 | −1.259 | −1.188 | −1.104 | −1.086 |
| RXC09 x HCC057 | Additional effect for enrollees with RXC 09 and HCC 057 | −0.355 | −0.286 | −0.198 | −0.098 | −0.069 |
| RXC09 x HCC048, 041 | Additional effect for enrollees with RXC 09 and (HCC 048 or 041) | −1.901 | −1.802 | −1.748 | −1.670 | −1.651 |
| RXC10 x HCC159, 158 | Additional effect for enrollees with RXC 10 and (HCC 159 or 158) | 36.448 | 36.460 | 36.625 | 36.751 | 36.785 |

2. On pages 6313 through 6316, the table titled “TABLE 2: Proposed Child Risk Adjustment Model Factors for the 2027 Benefit Year” is corrected to read as follows:

| Factor | Platinum | Gold | Silver | Bronze | Catastrophic |
| --- | --- | --- | --- | --- | --- |
|  |  |  |  |  |  |
| Age 2-4, Male | 0.297 | 0.217 | 0.162 | 0.118 | 0.106 |
| Age 5-9, Male | 0.222 | 0.154 | 0.113 | 0.085 | 0.077 |
| Age 10-14, Male | 0.210 | 0.146 | 0.108 | 0.082 | 0.076 |
| Age 15-20, Male | 0.246 | 0.179 | 0.132 | 0.097 | 0.088 |
| Age 2-4, Female | 0.237 | 0.166 | 0.124 | 0.092 | 0.084 |
| Age 5-9, Female | 0.162 | 0.102 | 0.067 | 0.044 | 0.039 |
| Age 10-14, Female | 0.216 | 0.153 | 0.115 | 0.089 | 0.082 |
| Age 15-20, Female | 0.267 | 0.187 | 0.124 | 0.077 | 0.063 |
|  |  |  |  |  |  |
| HIV/AIDS | 4.494 | 4.068 | 3.903 | 3.679 | 3.658 |
| Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock | 14.480 | 14.282 | 14.169 | 14.032 | 14.013 |
| Central Nervous System Infections, Except Viral Meningitis | 14.430 | 14.273 | 14.207 | 14.113 | 14.097 |
| Viral or Unspecified Meningitis | 12.991 | 12.869 | 12.785 | 12.679 | 12.655 |
| Opportunistic Infections | 20.233 | 20.191 | 20.119 | 20.039 | 20.013 |
| Metastatic Cancer | 31.479 | 31.228 | 31.163 | 31.056 | 31.045 |
| Lung, Brain, and Other Severe Cancers, Including Pediatric Acute Lymphoid Leukemia | 9.613 | 9.381 | 9.254 | 9.091 | 9.059 |
| Non-Hodgkin Lymphomas and Other Cancers and Tumors | 8.609 | 8.408 | 8.278 | 8.118 | 8.083 |
| Colorectal, Breast (Age <50), Kidney, and Other Cancers | 3.753 | 3.604 | 3.500 | 3.366 | 3.332 |
| Breast (Age 50+) and Prostate Cancer, Benign/Uncertain Brain Tumors, and Other Cancers and Tumors | 3.753 | 3.604 | 3.500 | 3.366 | 3.332 |
| Thyroid Cancer, Melanoma, Neurofibromatosis, and Other Cancers and Tumors | 1.204 | 1.092 | 0.978 | 0.855 | 0.818 |
| Pancreas Transplant Status | 11.308 | 11.349 | 11.403 | 11.462 | 11.475 |
| Diabetes with Acute Complications | 2.107 | 1.904 | 1.613 | 1.264 | 1.175 |
| Diabetes with Chronic Complications | 2.107 | 1.904 | 1.613 | 1.264 | 1.175 |
| Diabetes without Complication | 2.107 | 1.904 | 1.613 | 1.264 | 1.175 |
| Protein-Calorie Malnutrition | 17.913 | 17.788 | 17.745 | 17.685 | 17.674 |
| Mucopolysaccharidosis | 27.455 | 27.228 | 27.158 | 27.051 | 27.042 |
| Lipidoses and Glycogenosis | 27.455 | 27.228 | 27.158 | 27.051 | 27.042 |
| Congenital Metabolic Disorders, Not Elsewhere Classified | 4.860 | 4.741 | 4.671 | 4.584 | 4.566 |
| Amyloidosis, Porphyria, and Other Metabolic Disorders | 4.860 | 4.741 | 4.671 | 4.584 | 4.566 |
| Adrenal, Pituitary, and Other Significant Endocrine Disorders | 4.585 | 4.353 | 4.263 | 4.148 | 4.135 |
| Liver Transplant Status/Complications | 11.308 | 11.349 | 11.403 | 11.462 | 11.475 |
| Acute Liver Failure/Disease, Including Neonatal Hepatitis | 12.753 | 12.612 | 12.564 | 12.499 | 12.492 |
| Chronic Liver Failure/End-Stage Liver Disorders | 8.744 | 8.588 | 8.509 | 8.401 | 8.379 |
| Cirrhosis of Liver | 2.077 | 1.972 | 1.888 | 1.798 | 1.778 |
| Chronic Viral Hepatitis C | 2.077 | 1.972 | 1.888 | 1.798 | 1.778 |
| Chronic Hepatitis, Except Chronic Viral Hepatitis C | 1.367 | 1.287 | 1.195 | 1.098 | 1.073 |
| Intestine Transplant Status/Complications | 15.155 | 15.082 | 15.015 | 14.930 | 14.907 |
| Peritonitis/Gastrointestinal Perforation/Necrotizing Enterocolitis | 17.893 | 17.607 | 17.538 | 17.427 | 17.422 |
| Intestinal Obstruction | 3.920 | 3.746 | 3.616 | 3.458 | 3.423 |
| Chronic Pancreatitis | 9.814 | 9.635 | 9.554 | 9.449 | 9.434 |
| Acute Pancreatitis | 6.643 | 6.415 | 6.272 | 6.089 | 6.054 |
| Inflammatory Bowel Disease | 10.636 | 10.225 | 10.089 | 9.880 | 9.859 |
| Necrotizing Fasciitis | 4.686 | 4.490 | 4.367 | 4.224 | 4.197 |
| Bone/Joint/Muscle Infections/Necrosis | 4.686 | 4.490 | 4.367 | 4.224 | 4.197 |
| Rheumatoid Arthritis and Specified Autoimmune Disorders | 4.802 | 4.534 | 4.429 | 4.288 | 4.270 |
| Systemic Lupus Erythematosus and Other Autoimmune Disorders | 1.211 | 1.106 | 1.002 | 0.884 | 0.852 |
| Osteogenesis Imperfecta and Other Osteodystrophies | 1.112 | 1.008 | 0.919 | 0.822 | 0.799 |
| Congenital/Developmental Skeletal and Connective Tissue Disorders | 1.112 | 1.008 | 0.919 | 0.822 | 0.799 |
| Cleft Lip/Cleft Palate | 0.852 | 0.729 | 0.606 | 0.470 | 0.433 |
| Hemophilia | 59.554 | 59.072 | 58.973 | 58.779 | 58.763 |
| Myelodysplastic Syndromes and Myelofibrosis | 11.606 | 11.431 | 11.349 | 11.244 | 11.231 |
| Aplastic Anemia | 11.606 | 11.431 | 11.349 | 11.244 | 11.231 |
| Acquired Hemolytic Anemia, Including Hemolytic Disease of Newborn | 11.606 | 11.431 | 11.349 | 11.244 | 11.231 |
| Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero | 3.359 | 3.193 | 3.083 | 2.958 | 2.929 |
| Sickle-Cell Disorders, Except Sickle-Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major | 3.359 | 3.193 | 3.083 | 2.958 | 2.929 |
| Combined and Other Severe Immunodeficiencies | 5.693 | 5.547 | 5.470 | 5.368 | 5.350 |
| Disorders of the Immune Mechanism | 5.693 | 5.547 | 5.470 | 5.368 | 5.350 |
| Coagulation Defects and Other Specified Hematological Disorders | 4.135 | 4.022 | 3.937 | 3.839 | 3.817 |
| Drug Use with Psychotic Complications | 2.239 | 2.101 | 1.978 | 1.833 | 1.799 |
| Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications | 2.239 | 2.101 | 1.978 | 1.833 | 1.799 |
| Alcohol Use with Psychotic Complications | 0.811 | 0.683 | 0.540 | 0.377 | 0.338 |
| Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications | 0.811 | 0.683 | 0.540 | 0.377 | 0.338 |
| Schizophrenia | 3.875 | 3.617 | 3.437 | 3.224 | 3.185 |
| Delusional and Other Specified Psychotic Disorders, Unspecified Psychosis | 3.273 | 3.038 | 2.852 | 2.625 | 2.575 |
| Major Depressive Disorder, Severe, and Bipolar Disorders | 2.710 | 2.509 | 2.352 | 2.169 | 2.126 |
| Personality Disorders | 0.597 | 0.513 | 0.416 | 0.311 | 0.277 |
| Anorexia/Bulimia Nervosa | 2.132 | 1.994 | 1.886 | 1.751 | 1.717 |
| Prader-Willi, Patau, Edwards, and Autosomal Deletion Syndromes | 12.106 | 12.042 | 12.004 | 11.952 | 11.938 |
| Down Syndrome, Fragile X, Other Chromosomal Anomalies, and Congenital Malformation Syndromes | 0.799 | 0.693 | 0.601 | 0.491 | 0.463 |
| Autistic Disorder | 2.710 | 2.509 | 2.352 | 2.169 | 2.126 |
| Pervasive Developmental Disorders, Except Autistic Disorder | 0.597 | 0.513 | 0.416 | 0.321 | 0.297 |
| Traumatic Complete Lesion Cervical Spinal Cord | 10.342 | 10.139 | 10.066 | 9.954 | 9.944 |
| Quadriplegia | 10.342 | 10.139 | 10.066 | 9.954 | 9.944 |
| Traumatic Complete Lesion Dorsal Spinal Cord | 7.706 | 7.483 | 7.370 | 7.223 | 7.201 |
| Paraplegia | 7.706 | 7.483 | 7.370 | 7.223 | 7.201 |
| Spinal Cord Disorders/Injuries | 4.354 | 4.171 | 4.045 | 3.880 | 3.841 |
| Amyotrophic Lateral Sclerosis and Other Anterior Horn Cell Disease | 44.922 | 44.615 | 44.563 | 44.454 | 44.447 |
| Quadriplegic Cerebral Palsy | 1.301 | 1.125 | 1.017 | 0.881 | 0.861 |
| Cerebral Palsy, Except Quadriplegic | 0.394 | 0.278 | 0.202 | 0.113 | 0.091 |
| Spina Bifida and Other Brain/Spinal/Nervous System Congenital Anomalies | 1.403 | 1.295 | 1.208 | 1.102 | 1.078 |
| Myasthenia Gravis/Myoneural Disorders and Guillain-Barre Syndrome/Inflammatory and Toxic Neuropathy | 11.196 | 11.067 | 11.035 | 10.986 | 10.988 |
| Muscular Dystrophy | 6.335 | 6.182 | 6.087 | 5.966 | 5.942 |
| Multiple Sclerosis | 7.535 | 7.183 | 7.067 | 6.898 | 6.885 |
| Parkinson's, Huntington's, and Spinocerebellar Disease, and Other Neurodegenerative Disorders | 6.335 | 6.182 | 6.087 | 5.966 | 5.942 |
| Seizure Disorders and Convulsions | 1.519 | 1.389 | 1.256 | 1.104 | 1.063 |
| Hydrocephalus | 11.643 | 11.592 | 11.599 | 11.603 | 11.602 |
| Nontraumatic Coma, Except Diabetic, Hepatic, or Hypoglycemic; Nontraumatic Brain Compression/Anoxic Damage | 11.490 | 11.480 | 11.484 | 11.487 | 11.485 |
| Narcolepsy and Cataplexy | 3.550 | 3.402 | 3.296 | 3.156 | 3.115 |
| Respirator Dependence/Tracheostomy Status | 26.852 | 26.609 | 26.531 | 26.418 | 26.408 |
| Respiratory Arrest | 15.129 | 14.889 | 14.754 | 14.581 | 14.559 |
| Cardio-Respiratory Failure and Shock, Including Respiratory Distress Syndromes | 15.129 | 14.889 | 14.754 | 14.581 | 14.559 |
| Heart Assistive Device/Artificial Heart | 15.155 | 15.082 | 15.015 | 14.930 | 14.907 |
| Heart Transplant Status/Complications | 15.155 | 15.082 | 15.015 | 14.930 | 14.907 |
| Heart Failure | 3.656 | 3.549 | 3.481 | 3.391 | 3.370 |
| Acute Myocardial Infarction | 0.225 | 0.196 | 0.157 | 0.107 | 0.088 |
| Unstable Angina and Other Acute Ischemic Heart Disease | 0.225 | 0.196 | 0.157 | 0.107 | 0.088 |
| Heart Infection/Inflammation, Except Rheumatic | 15.433 | 15.322 | 15.236 | 15.136 | 15.111 |
| Hypoplastic Left Heart Syndrome and Other Severe Congenital Heart Disorders | 3.711 | 3.564 | 3.444 | 3.307 | 3.273 |
| Major Congenital Heart/Circulatory Disorders | 0.962 | 0.862 | 0.757 | 0.652 | 0.624 |
| Atrial and Ventricular Septal Defects, Patent Ductus Arteriosus, and Other Congenital Heart/Circulatory Disorders | 0.525 | 0.439 | 0.352 | 0.268 | 0.248 |
| Specified Heart Arrhythmias | 3.136 | 2.983 | 2.882 | 2.759 | 2.732 |
| Intracranial Hemorrhage | 12.158 | 12.048 | 12.010 | 11.963 | 11.955 |
| Ischemic or Unspecified Stroke | 0.531 | 0.420 | 0.353 | 0.272 | 0.255 |
| Cerebral Aneurysm and Arteriovenous Malformation | 0.813 | 0.690 | 0.607 | 0.502 | 0.480 |
| Hemiplegia/Hemiparesis | 4.230 | 4.089 | 3.989 | 3.861 | 3.834 |
| Monoplegia, Other Paralytic Syndromes | 2.776 | 2.633 | 2.537 | 2.417 | 2.392 |
| Atherosclerosis of the Extremities with Ulceration or Gangrene | 10.094 | 9.865 | 9.741 | 9.588 | 9.568 |
| Vascular Disease with Complications | 12.595 | 12.449 | 12.389 | 12.300 | 12.286 |
| Pulmonary Embolism and Deep Vein Thrombosis | 19.285 | 19.147 | 19.070 | 18.968 | 18.947 |
| Lung Transplant Status/Complications | 15.155 | 15.082 | 15.015 | 14.930 | 14.907 |
| Cystic Fibrosis | 49.902 | 49.319 | 49.258 | 49.095 | 49.105 |
| Chronic Obstructive Pulmonary Disease, Including Bronchiectasis | 1.825 | 1.669 | 1.534 | 1.379 | 1.342 |
| Severe Asthma | 1.253 | 1.093 | 0.929 | 0.748 | 0.704 |
| Asthma, Except Severe | 0.323 | 0.248 | 0.165 | 0.092 | 0.072 |
| Fibrosis of Lung and Other Lung Disorders | 1.444 | 1.329 | 1.211 | 1.083 | 1.051 |
| Aspiration and Specified Bacterial Pneumonias and Other Severe Lung Infections | 11.365 | 11.349 | 11.403 | 11.462 | 11.475 |
| Kidney Transplant Status/Complications | 11.308 | 11.349 | 11.403 | 11.462 | 11.475 |
| End Stage Renal Disease | 23.942 | 23.682 | 23.657 | 23.578 | 23.576 |
| Chronic Kidney Disease, Stage 5 | 2.630 | 2.522 | 2.430 | 2.344 | 2.325 |
| Chronic Kidney Disease, Severe (Stage 4) | 2.630 | 2.522 | 2.430 | 2.344 | 2.325 |
| Ectopic and Molar Pregnancy | 0.988 | 0.833 | 0.642 | 0.431 | 0.386 |
| Miscarriage with Complications | 0.526 | 0.409 | 0.233 | 0.036 | 0.005 |
| Miscarriage with No or Minor Complications | 0.526 | 0.409 | 0.233 | 0.036 | 0.005 |
| Pregnancy with Delivery with Major Complications | 3.019 | 2.757 | 2.391 | 1.934 | 1.805 |
| Pregnancy with Delivery with Complications | 3.019 | 2.757 | 2.391 | 1.934 | 1.805 |
| Pregnancy with Delivery with No or Minor Complications | 2.183 | 1.972 | 1.629 | 1.180 | 1.023 |
| (Ongoing) Pregnancy without Delivery with Major Complications | 0.513 | 0.378 | 0.189 | 0.011 | 0.000 |
| (Ongoing) Pregnancy without Delivery with Complications | 0.513 | 0.378 | 0.189 | 0.011 | 0.000 |
| (Ongoing) Pregnancy without Delivery with No or Minor Complications | 0.284 | 0.182 | 0.068 | 0.000 | 0.000 |
| Chronic Ulcer of Skin, Except Pressure | 2.113 | 2.020 | 1.939 | 1.855 | 1.833 |
| Extensive Third Degree Burns | 22.256 | 22.021 | 21.922 | 21.792 | 21.772 |
| Major Skin Burn or Condition | 2.590 | 2.420 | 2.281 | 2.120 | 2.083 |
| Severe Head Injury | 22.256 | 22.021 | 21.922 | 21.792 | 21.772 |
| Hip and Pelvic Fractures | 4.114 | 3.906 | 3.772 | 3.623 | 3.596 |
| Vertebral Fractures without Spinal Cord Injury | 4.144 | 3.952 | 3.811 | 3.639 | 3.600 |
| Traumatic Amputations and Amputation Complications | 3.694 | 3.520 | 3.372 | 3.192 | 3.147 |
| Stem Cell, Including Bone Marrow, Transplant Status/Complications | 15.155 | 15.082 | 15.015 | 14.930 | 14.907 |
| Artificial Openings for Feeding or Elimination | 4.495 | 4.323 | 4.257 | 4.161 | 4.151 |
| Amputation Status, Upper Limb or Lower Limb | 3.694 | 3.520 | 3.372 | 3.192 | 3.147 |
|  |  |  |  |  |  |
| Severe illness, 1 payment HCC | −11.308 | −11.349 | −11.403 | −11.462 | −11.475 |
| Severe illness, 2 payment HCCs | −11.308 | −11.349 | −11.403 | −11.462 | −11.475 |
| Severe illness, 3 payment HCCs | −10.149 | −10.211 | −10.174 | −10.162 | −10.141 |
| Severe illness, 4 payment HCCs | −9.055 | −9.082 | −8.919 | −8.762 | −8.697 |
| Severe illness, 5 payment HCCs | −8.454 | −8.416 | −8.172 | −7.938 | −7.853 |
| Severe illness, 6 or 7 payment HCCs | −4.190 | −3.978 | −3.561 | −3.133 | −3.003 |
| Severe illness, 8 or more payment HCCs | 18.133 | 18.860 | 19.604 | 20.422 | 20.625 |
| Transplant severe illness, 4 or more payment HCCs | 15.299 | 15.306 | 15.287 | 15.271 | 15.267 |
|  |  |  |  |  |  |
| HIV Pre-Exposure Prophylaxis (PrEP) | 2.089 | 2.042 | 1.984 | 1.923 | 1.905 |

3. On page 6317, the table titled “TABLE 3: HHS HCCs Selected for the HCC Interacted Counts Variables for the Adult and Child Models for the 2027 Benefit Year” is corrected to read as follows:

| Payment HCC | Severity illness | Transplant |
| --- | --- | --- |
| HCC 2 Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock | X |  |
| HCC 3 Central Nervous System Infections, Except Viral Meningitis | X |  |
| HCC 4 Viral or Unspecified Meningitis | X |  |
| HCC 6 Opportunistic Infections | X |  |
| HCC 23 Protein-Calorie Malnutrition | X |  |
| HCC 34 Liver Transplant Status/Complications | X | X |
| HCC 41 Intestine Transplant Status/Complications | X | X |
| HCC 42 Peritonitis/Gastrointestinal Perforation/Necrotizing Enterocolitis | X |  |
| HCC 96 Prader-Willi, Patau, Edwards, and Autosomal Deletion Syndromes | X |  |
| HCC 121 Hydrocephalus | X |  |
| HCC 122 Nontraumatic Coma, Except Diabetic, Hepatic, or Hypoglycemic; Nontraumatic Brain Compression/Anoxic Damage | X |  |
| HCC 125 Respirator Dependence/Tracheostomy Status | X |  |
| HCC 135 Heart Infection/Inflammation, Except Rheumatic | X |  |
| HCC 145 Intracranial Hemorrhage | X |  |
| HCC 156 Pulmonary Embolism and Deep Vein Thrombosis | X |  |
| HCC 158 Lung Transplant Status/Complications | X | X |
| HCC 163 Aspiration and Specified Bacterial Pneumonias and Other Severe Lung Infections | X |  |
| HCC 218 Extensive Third Degree Burns | X |  |
| HCC 223 Severe Head Injury | X |  |
| HCC 251 Stem Cell, Including Bone Marrow, Transplant Status/Complications | X | X |
| G13 (Includes HCC 126 Respiratory Arrest and HCC 127 Cardio-Respiratory Failure and Shock, Including Respiratory Distress Syndromes) | X |  |
| G14 (Includes HCC 128 Heart Assistive Device/Artificial Heart and HCC 129 Heart Transplant Status/Complications) | X | X |
| G24 (Includes HCC 18 Pancreas Transplant Status and HCC 183 Kidney Transplant Status/Complications) | X | X |

4. On page 6318, top half of the page, the table titled “TABLE 4: Proposed Infant Risk Adjustment Model Factors for the 2027 Benefit Year” is corrected to read as follows:

| Group | Platinum | Gold | Silver | Bronze | Catastrophic |
| --- | --- | --- | --- | --- | --- |
| Extremely Immature * Severity Level 5 (Highest) | 197.671 | 196.159 | 195.801 | 195.221 | 195.198 |
| Extremely Immature * Severity Level 4 | 129.748 | 128.048 | 127.479 | 126.693 | 126.619 |
| Extremely Immature * Severity Level 3 | 29.087 | 27.703 | 27.191 | 26.528 | 26.453 |
| Extremely Immature * Severity Level 2 | 29.087 | 27.703 | 27.191 | 26.528 | 26.453 |
| Extremely Immature * Severity Level 1 (Lowest) | 29.087 | 27.703 | 27.191 | 26.528 | 26.453 |
| Immature * Severity Level 5 (Highest) | 123.452 | 121.973 | 121.649 | 121.124 | 121.107 |
| Immature * Severity Level 4 | 67.497 | 65.845 | 65.420 | 64.760 | 64.712 |
| Immature * Severity Level 3 | 29.087 | 27.703 | 27.191 | 26.528 | 26.453 |
| Immature * Severity Level 2 | 22.383 | 21.155 | 20.619 | 19.967 | 19.876 |
| Immature * Severity Level 1 (Lowest) | 21.881 | 20.636 | 20.094 | 19.436 | 19.346 |
| Premature/Multiples * Severity Level 5 (Highest) | 107.440 | 105.978 | 105.584 | 105.002 | 104.960 |
| Premature/Multiples * Severity Level 4 | 27.962 | 26.600 | 26.069 | 25.389 | 25.317 |
| Premature/Multiples * Severity Level 3 | 12.192 | 11.287 | 10.647 | 9.906 | 9.741 |
| Premature/Multiples * Severity Level 2 | 7.667 | 6.967 | 6.351 | 5.654 | 5.480 |
| Premature/Multiples * Severity Level 1 (Lowest) | 5.481 | 4.884 | 4.306 | 3.679 | 3.503 |
| Term * Severity Level 5 (Highest) | 80.094 | 78.884 | 78.453 | 77.860 | 77.791 |
| Term * Severity Level 4 | 16.487 | 15.512 | 14.880 | 14.150 | 14.017 |
| Term * Severity Level 3 | 5.490 | 4.920 | 4.339 | 3.704 | 3.528 |
| Term * Severity Level 2 | 3.764 | 3.279 | 2.717 | 2.108 | 1.931 |
| Term * Severity Level 1 (Lowest) | 2.081 | 1.689 | 1.247 | 0.869 | 0.778 |
| Age1 * Severity Level 5 (Highest) | 69.546 | 68.851 | 68.623 | 68.313 | 68.286 |
| Age1 * Severity Level 4 | 12.005 | 11.504 | 11.187 | 10.827 | 10.759 |
| Age1 * Severity Level 3 | 2.842 | 2.580 | 2.365 | 2.151 | 2.097 |
| Age1 * Severity Level 2 | 1.802 | 1.576 | 1.352 | 1.132 | 1.070 |
| Age1 * Severity Level 1 (Lowest) | 0.569 | 0.478 | 0.421 | 0.380 | 0.368 |
| Age 0 Male | 0.498 | 0.460 | 0.421 | 0.360 | 0.340 |
| Age 1 Male | 0.067 | 0.052 | 0.032 | 0.011 | 0.007 |

5. On page 6318, bottom half of the page, the table titled “TABLE 5: HHS HCCs Included in Infant Model Maturity Categories” is corrected to read as follows:

| Maturity category | HCC/description |
| --- | --- |
| Extremely Immature | Extremely Immature Newborns, Birth weight <500 Grams. |
| Extremely Immature | Extremely Immature Newborns, Including Birth weight 500-749 Grams. |
| Extremely Immature | Extremely Immature Newborns, Including Birth weight 750-999 Grams. |
| Immature | Premature Newborns, Including Birth weight 1000-1499 Grams. |
| Immature | Premature Newborns, Including Birth weight 1500-1999 Grams. |
| Premature/Multiples | Premature Newborns, Including Birth weight 2000-2499 Grams. |
| Premature/Multiples | Other Premature, Low Birth weight, Malnourished, or Multiple Birth Newborns. |
| Term | Term or Post-Term Singleton Newborn, Normal or High Birth weight. |
| Age 1 | All age 1 infants. |

6. On page 6319 through the top half of page 6321, the table titled “TABLE 6: HHS HCCs Included in Infant Model Severity Categories” is corrected to read as follows:

| Severity category | HCC/description |
| --- | --- |
| Severity Level 5 (Highest) | Metastatic Cancer. |
| Severity Level 5 | Pancreas Transplant Status. |
| Severity Level 5 | Liver Transplant Status/Complications. |
| Severity Level 5 | Intestine Transplant Status/Complications. |
| Severity Level 5 | Peritonitis/Gastrointestinal Perforation/Necrotizing Enterocolitis. |
| Severity Level 5 | Respirator Dependence/Tracheostomy Status. |
| Severity Level 5 | Heart Assistive Device/Artificial Heart. |
| Severity Level 5 | Heart Transplant Status/Complications. |
| Severity Level 5 | Heart Failure. |
| Severity Level 5 | Hypoplastic Left Heart Syndrome and Other Severe Congenital Heart Disorders. |
| Severity Level 5 | Lung Transplant Status/Complications. |
| Severity Level 5 | Kidney Transplant Status/Complications. |
| Severity Level 5 | End Stage Renal Disease. |
| Severity Level 5 | Stem Cell, Including Bone Marrow, Transplant Status/Complications. |
| Severity Level 4 | Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock. |
| Severity Level 4 | Lung, Brain, and Other Severe Cancers, Including Pediatric Acute Lymphoid Leukemia. |
| Severity Level 4 | Mucopolysaccharidosis. |
| Severity Level 4 | Adrenal, Pituitary, and Other Significant Endocrine Disorders. |
| Severity Level 4 | Acute Liver Failure/Disease, Including Neonatal Hepatitis. |
| Severity Level 4 | Chronic Liver Failure/End-Stage Liver Disorders. |
| Severity Level 4 | Major Congenital Anomalies of Diaphragm, Abdominal Wall, and Esophagus, Age <2. |
| Severity Level 4 | Myelodysplastic Syndromes and Myelofibrosis. |
| Severity Level 4 | Aplastic Anemia. |
| Severity Level 4 | Combined and Other Severe Immunodeficiencies. |
| Severity Level 4 | Traumatic Complete Lesion Cervical Spinal Cord. |
| Severity Level 4 | Quadriplegia. |
| Severity Level 4 | Amyotrophic Lateral Sclerosis and Other Anterior Horn Cell Disease. |
| Severity Level 4 | Quadriplegic Cerebral Palsy. |
| Severity Level 4 | Myasthenia Gravis/Myoneural Disorders and Guillain-Barre Syndrome/Inflammatory and Toxic Neuropathy. |
| Severity Level 4 | Nontraumatic Coma, Except Diabetic, Hepatic, or Hypoglycemic; Nontraumatic Brain Compression/Anoxic Damage. |
| Severity Level 4 | Respiratory Arrest. |
| Severity Level 4 | Cardio-Respiratory Failure and Shock, Including Respiratory Distress Syndromes. |
| Severity Level 4 | Acute Myocardial Infarction. |
| Severity Level 4 | Heart Infection/Inflammation, Except Rheumatic. |
| Severity Level 4 | Major Congenital Heart/Circulatory Disorders. |
| Severity Level 4 | Intracranial Hemorrhage. |
| Severity Level 4 | Ischemic or Unspecified Stroke. |
| Severity Level 4 | Vascular Disease with Complications. |
| Severity Level 4 | Pulmonary Embolism and Deep Vein Thrombosis. |
| Severity Level 4 | Aspiration and Specified Bacterial Pneumonias and Other Severe Lung Infections. |
| Severity Level 4 | Chronic Kidney Disease, Stage 5. |
| Severity Level 4 | Artificial Openings for Feeding or Elimination. |
| Severity Level 3 | HIV/AIDS. |
| Severity Level 3 | Central Nervous System Infections, Except Viral Meningitis. |
| Severity Level 3 | Opportunistic Infections. |
| Severity Level 3 | Non-Hodgkin Lymphomas and Other Cancers and Tumors. |
| Severity Level 3 | Colorectal, Breast (Age <50), Kidney, and Other Cancers. |
| Severity Level 3 | Breast (Age 50+) and Prostate Cancer, Benign/Uncertain Brain Tumors, and Other Cancers and Tumors. |
| Severity Level 3 | Lipidoses and Glycogenosis. |
| Severity Level 3 | Intestinal Obstruction. |
| Severity Level 3 | Necrotizing Fasciitis. |
| Severity Level 3 | Bone/Joint/Muscle Infections/Necrosis. |
| Severity Level 3 | Osteogenesis Imperfecta and Other Osteodystrophies. |
| Severity Level 3 | Cleft Lip/Cleft Palate. |
| Severity Level 3 | Hemophilia. |
| Severity Level 3 | Sickle Cell Anemia (Hb-SS) and Thalassemia Beta Zero. |
| Severity Level 3 | Disorders of the Immune Mechanism. |
| Severity Level 3 | Coagulation Defects and Other Specified Hematological Disorders. |
| Severity Level 3 | Drug Use with Psychotic Complications. |
| Severity Level 3 | Drug Use Disorder, Moderate/Severe, or Drug Use with Non-Psychotic Complications. |
| Severity Level 3 | Alcohol Use with Psychotic Complications. |
| Severity Level 3 | Alcohol Use Disorder, Moderate/Severe, or Alcohol Use with Specified Non-Psychotic Complications. |
| Severity Level 3 | Prader-Willi, Patau, Edwards, and Autosomal Deletion Syndromes. |
| Severity Level 3 | Traumatic Complete Lesion Dorsal Spinal Cord. |
| Severity Level 3 | Paraplegia. |
| Severity Level 3 | Spinal Cord Disorders/Injuries. |
| Severity Level 3 | Cerebral Palsy, Except Quadriplegic. |
| Severity Level 3 | Spina Bifida and Other Brain/Spinal/Nervous System Congenital Anomalies. |
| Severity Level 3 | Muscular Dystrophy. |
| Severity Level 3 | Parkinson's, Huntington's, and Spinocerebellar Disease, and Other Neurodegenerative Disorders. |
| Severity Level 3 | Hydrocephalus. |
| Severity Level 3 | Unstable Angina and Other Acute Ischemic Heart Disease. |
| Severity Level 3 | Atrial and Ventricular Septal Defects, Patent Ductus Arteriosus, and Other Congenital Heart/Circulatory Disorders. |
| Severity Level 3 | Specified Heart Arrhythmias. |
| Severity Level 3 | Cerebral Aneurysm and Arteriovenous Malformation. |
| Severity Level 3 | Hemiplegia/Hemiparesis. |
| Severity Level 3 | Cystic Fibrosis. |
| Severity Level 3 | Extensive Third Degree Burns. |
| Severity Level 3 | Severe Head Injury. |
| Severity Level 3 | Hip and Pelvic Fractures. |
| Severity Level 3 | Vertebral Fractures without Spinal Cord Injury. |
| Severity Level 2 | Viral or Unspecified Meningitis. |
| Severity Level 2 | Thyroid Cancer, Melanoma, Neurofibromatosis, and Other Cancers and Tumors. |
| Severity Level 2 | Diabetes with Acute Complications. |
| Severity Level 2 | Diabetes with Chronic Complications. |
| Severity Level 2 | Diabetes without Complication. |
| Severity Level 2 | Protein-Calorie Malnutrition. |
| Severity Level 2 | Congenital Metabolic Disorders, Not Elsewhere Classified. |
| Severity Level 2 | Amyloidosis, Porphyria, and Other Metabolic Disorders. |
| Severity Level 2 | Cirrhosis of Liver. |
| Severity Level 2 | Chronic Pancreatitis. |
| Severity Level 2 | Acute Pancreatitis. |
| Severity Level 2 | Inflammatory Bowel Disease. |
| Severity Level 2 | Rheumatoid Arthritis and Specified Autoimmune Disorders. |
| Severity Level 2 | Systemic Lupus Erythematosus and Other Autoimmune Disorders. |
| Severity Level 2 | Congenital/Developmental Skeletal and Connective Tissue Disorders. |
| Severity Level 2 | Acquired Hemolytic Anemia, Including Hemolytic Disease of Newborn. |
| Severity Level 2 | Sickle-Cell Disorders, Except Sickle-Cell Anemia (Hb-SS) and Thalassemia Beta Zero; Beta Thalassemia Major. |
| Severity Level 2 | Down Syndrome, Fragile X, Other Chromosomal Anomalies, and Congenital Malformation Syndromes. |
| Severity Level 2 | Seizure Disorders and Convulsions. |
| Severity Level 2 | Monoplegia, Other Paralytic Syndromes. |
| Severity Level 2 | Atherosclerosis of the Extremities with Ulceration or Gangrene. |
| Severity Level 2 | Chronic Obstructive Pulmonary Disease, Including Bronchiectasis. |
| Severity Level 2 | Severe Asthma. |
| Severity Level 2 | Fibrosis of Lung and Other Lung Disorders. |
| Severity Level 2 | Chronic Kidney Disease, Severe (Stage 4). |
| Severity Level 2 | Chronic Ulcer of Skin, Except Pressure. |
| Severity Level 2 | Major Skin Burn or Condition. |
| Severity Level 1 (Lowest) | Chronic Viral Hepatitis C. |
| Severity Level 1 | Chronic Hepatitis, Except Chronic Viral Hepatitis C. |
| Severity Level 1 | Autistic Disorder. |
| Severity Level 1 | Pervasive Developmental Disorders, Except Autistic Disorder. |
| Severity Level 1 | Multiple Sclerosis. |
| Severity Level 1 | Asthma, Except Severe. |
| Severity Level 1 | Traumatic Amputations and Amputation Complications. |
| Severity Level 1 | Amputation Status, Upper Limb or Lower Limb. |

7. On page 6321, bottom half of the page, the table titled “TABLE 7: R-Squared Statistics for Proposed 2027 Benefit Year HHS Risk Adjustment Models” is corrected to read as follows:

| Model | BY2021 | BY2022 | BY2023 |
| --- | --- | --- | --- |
| Platinum Adult | 0.4213 | 0.4094 | 0.4152 |
| Gold Adult | 0.4154 | 0.4032 | 0.4089 |
| Silver Adult | 0.4122 | 0.3996 | 0.4048 |
| Bronze Adult | 0.4077 | 0.3948 | 0.3996 |
| Catastrophic Adult | 0.4068 | 0.3937 | 0.3982 |
| Platinum Child | 0.3569 | 0.3639 | 0.3412 |
| Gold Child | 0.3540 | 0.3612 | 0.3381 |
| Silver Child | 0.3516 | 0.3588 | 0.3357 |
| Bronze Child | 0.3484 | 0.3555 | 0.3324 |
| Catastrophic Child | 0.3474 | 0.3545 | 0.3314 |
| Platinum Infant | 0.3099 | 0.2883 | 0.2727 |
| Gold Infant | 0.3062 | 0.2847 | 0.2687 |
| Silver Infant | 0.3044 | 0.2827 | 0.2667 |
| Bronze Infant | 0.3019 | 0.2802 | 0.2640 |
| Catastrophic Infant | 0.3014 | 0.2797 | 0.2635 |

Liesl I. Fowler,

Executive Secretary to the Department, Department of Health and Human Services.