TRICARE Formerly Known as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); Fiscal Year 2005 Puerto Rico Region Specific Mental Health Rates, 43400 [05-14844]

Download as PDF 43400 Federal Register / Vol. 70, No. 143 / Wednesday, July 27, 2005 / Notices J) must be manufactured by one of the companies in the list below in ‘‘i through xi’’: i. African Textile Manufacturers Ltd ii. Angel Spinning & Dyeing Ltd iii. Bhojraj Industries PLC iv. Dangote General Textile Products, Ltd v. General Cotton Mills Ltd vi. Gaskiya Textile Mills PLC vii. Holborn Nigeria Ltd viii. Hong Kong Synthetic Fibre Co. Nig Ltd ix. Reliance Textile Industries Ltd x. Sunflag Nig Ltd xi. United Nigerian Textiles PLC [FR Doc. E5–4004 Filed 7–26–05; 8:45 am] BILLING CODE 3510–DS–S DEPARTMENT OF DEFENSE Office of the Secretary TRICARE Formerly Known as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); Fiscal Year 2005 Puerto Rico Region Specific Mental Health Rates Office of the Secretary, DoD. Notice of rate setting; establishment of region specific Puerto Rico Mental Health rates. AGENCY: ACTION: This notice provides for the establishment of a Puerto Rico region specific per diem rates for low volume providers; the establishment of region specific per diem rates for both full-day and half-day TRICARE Partial Hospitalization Programs under the TRICARE Mental Health Per Diem Payment System for fiscal year 2005. EFFECTIVE DATE: The fiscal year 2005 rates contained in this notice are SUMMARY: effective for services occurring on or after September 1, 2005. FOR FURTHER INFORMATION CONTACT: Christine Gavlick, Office of Medical Benefits and Reimbursement Systems, TRICARE Management Activity, telephone (303) 676–3841. SUPPLEMENTARY INFORMATION: The final rule published in the Federal Register on September 6, 1988, (53 FR 34285) set forth reimbursement methodologies that were effective for all inpatient hospital admissions in psychiatric hospitals and exempt psychiatric units occurring on or after January 1, 1989. This final rule uses regionally established per diems to pay hospitals that do not have enough CHAMPUS discharges upon which to base a valid hospital-specific rate. Regional rates incorporate adjustments for area wage differences, indirect medical educations costs and pass through payments for direct medical education costs. Mental Health partial hospitalization programs are also reimbursed according to regional per diems. The Mental Health regional per diems are applied utilizing the designated Federal Census regions. By 32 CFR 199.14(a)(2)(viii)(E), the commonwealth of Puerto Rico is subject to TRICARE’s mental halth reimbursement methodologies. Since Puerto Rico is not incorporated in a Federal Census Region, this notice establishes a Puerto Rico region specific per diem as well as region specific rates for partial hospitalization programs, both full day and half-day programs. TRICARE additionally published in the Federal Register on July 1, 1993, (58 FR 35–400) final rules that set forth maximum per diem rates for all partial hospitalization admissions on or after September 29, 1993. Included in these final rules were provisions for updating reimbursement rates for each federal fiscal year. As stated in the final rules, each per diem shall be updated by the Medicare update factor for hospitals and units exempt from the Medicare Prospective Payment System. For fiscal year 2005, Medicare has recommended a rate of increase of 3.3 percent for hospitals and units excluded from the prospective payment system. TRICARE has incorporated this update factor for FY 2005 in the determinaion of the region specific Puerto Rico rates. Consistent with Medicare, the wage portion of the regional rate subject to the area wage adjustment is 71.56 percent for FY 2005. The following reflects the Puerto Rico region specific rates: REGION SPECIFIC RATES FOR PSYCHIATRIC HOSPITALS AND UNITS WITH LOW TRICARE VOLUME United States region Rate1 Puerto Rico ................................... $434.00 1 Wage portion of the rate, subject to the area wage adjustment—71.56 percent. Beneficiary Cost-Share: Beneficiary cost-share (other than dependents of active duty members) for care paid on the basis of a regional per diem rate is the lower of $169 per day or 25 percent of the hospital billed charges effective for services rendered on or after October 1, 2004. PUERTO RICO REGION SPECIFIC PARTIAL HOSPITALIZATION RATES FOR FULL-TIME DAY AND HALF-DAY PROGRAMS FY 2005 United States region Full-day rate (6 hours or more) Puerto Rico ............................................................................... $183 ......................................................................................... (Half-day rate (3–5 hours) $138 The above rates are effective for services rendered on or after September 1, 2005. DEPARTMENT OF DEFENSE Correction Office of the Secretary Dated: July 22, 2005. L.M. Bynum, Alternate OSD Federal Register, Liaison Officer, Department of Defense. [FR Doc. 05–14844 Filed 7–26–05; 8:45 am] Notice of the Defense Business Board Meeting—Correction In the Federal Register of July 22, 2005, page 36377 FR Doc. 05–14534, in the middle column, the last sentence in the SUMMARY is amended to read: ‘‘The delay in publishing this Notice was due to technical difficulties in obtaining the information.’’ BILLING CODE 5001–06–M SUMMARY: The Department of Defense published an Open Meeting notice on the Defense Business Board on July 22, 2005. This Notice is published to include justification for not publishing the Notice within the 15-day requirement. VerDate jul<14>2003 19:40 Jul 26, 2005 Jkt 205001 Department of Defense. Notice; correction. AGENCY: ACTION: PO 00000 Frm 00011 Fmt 4703 Sfmt 4703 Dated: July 22, 2005. Jeannette Owings-Ballard, Alternate OSD Federal Register Liaison Officer, Department of Defense. [FR Doc. 05–14846 Filed 7–26–05; 8:45 am] BILLING CODE 5001–06–M E:\FR\FM\27JYN1.SGM 27JYN1

Agencies

[Federal Register Volume 70, Number 143 (Wednesday, July 27, 2005)]
[Notices]
[Page 43400]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-14844]


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DEPARTMENT OF DEFENSE

Office of the Secretary


TRICARE Formerly Known as the Civilian Health and Medical Program 
of the Uniformed Services (CHAMPUS); Fiscal Year 2005 Puerto Rico 
Region Specific Mental Health Rates

AGENCY: Office of the Secretary, DoD.

ACTION: Notice of rate setting; establishment of region specific Puerto 
Rico Mental Health rates.

-----------------------------------------------------------------------

SUMMARY: This notice provides for the establishment of a Puerto Rico 
region specific per diem rates for low volume providers; the 
establishment of region specific per diem rates for both full-day and 
half-day TRICARE Partial Hospitalization Programs under the TRICARE 
Mental Health Per Diem Payment System for fiscal year 2005.

EFFECTIVE DATE: The fiscal year 2005 rates contained in this notice are 
effective for services occurring on or after September 1, 2005.

FOR FURTHER INFORMATION CONTACT: Christine Gavlick, Office of Medical 
Benefits and Reimbursement Systems, TRICARE Management Activity, 
telephone (303) 676-3841.

SUPPLEMENTARY INFORMATION: The final rule published in the Federal 
Register on September 6, 1988, (53 FR 34285) set forth reimbursement 
methodologies that were effective for all inpatient hospital admissions 
in psychiatric hospitals and exempt psychiatric units occurring on or 
after January 1, 1989. This final rule uses regionally established per 
diems to pay hospitals that do not have enough CHAMPUS discharges upon 
which to base a valid hospital-specific rate. Regional rates 
incorporate adjustments for area wage differences, indirect medical 
educations costs and pass through payments for direct medical education 
costs. Mental Health partial hospitalization programs are also 
reimbursed according to regional per diems. The Mental Health regional 
per diems are applied utilizing the designated Federal Census regions. 
By 32 CFR 199.14(a)(2)(viii)(E), the commonwealth of Puerto Rico is 
subject to TRICARE's mental halth reimbursement methodologies. Since 
Puerto Rico is not incorporated in a Federal Census Region, this notice 
establishes a Puerto Rico region specific per diem as well as region 
specific rates for partial hospitalization programs, both full day and 
half-day programs. TRICARE additionally published in the Federal 
Register on July 1, 1993, (58 FR 35-400) final rules that set forth 
maximum per diem rates for all partial hospitalization admissions on or 
after September 29, 1993. Included in these final rules were provisions 
for updating reimbursement rates for each federal fiscal year. As 
stated in the final rules, each per diem shall be updated by the 
Medicare update factor for hospitals and units exempt from the Medicare 
Prospective Payment System. For fiscal year 2005, Medicare has 
recommended a rate of increase of 3.3 percent for hospitals and units 
excluded from the prospective payment system. TRICARE has incorporated 
this update factor for FY 2005 in the determinaion of the region 
specific Puerto Rico rates. Consistent with Medicare, the wage portion 
of the regional rate subject to the area wage adjustment is 71.56 
percent for FY 2005.
    The following reflects the Puerto Rico region specific rates:

   Region Specific Rates for Psychiatric Hospitals and Units With Low
                             Tricare Volume
------------------------------------------------------------------------
                     United States region                        Rate1
------------------------------------------------------------------------
Puerto Rico..................................................   $434.00
------------------------------------------------------------------------
\1\ Wage portion of the rate, subject to the area wage adjustment--71.56
  percent.

    Beneficiary Cost-Share: Beneficiary cost-share (other than 
dependents of active duty members) for care paid on the basis of a 
regional per diem rate is the lower of $169 per day or 25 percent of 
the hospital billed charges effective for services rendered on or after 
October 1, 2004.

 Puerto Rico Region Specific Partial Hospitalization Rates For Full-Time
                    Day and Half-Day Programs FY 2005
------------------------------------------------------------------------
                                   Full-day rate  (6     (Half-day rate
     United States region           hours or more)         (3-5 hours)
------------------------------------------------------------------------
Puerto Rico...................  $183..................             $138
------------------------------------------------------------------------

    The above rates are effective for services rendered on or after 
September 1, 2005.

    Dated: July 22, 2005.
L.M. Bynum,
Alternate OSD Federal Register, Liaison Officer, Department of Defense.
[FR Doc. 05-14844 Filed 7-26-05; 8:45 am]
BILLING CODE 5001-06-M

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