Expansion of a TRICARE Demonstration Project for the State of Alaska, 41501-41502 [E7-14681]
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Federal Register / Vol. 72, No. 145 / Monday, July 30, 2007 / Notices
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Strategic Plan and to submit relevant
collaboration proposals.
On February 8, 2006, the Corporation
released its Strategic Plan for 2006–
2010. The plan, which benefited from
extensive public input, is a blueprint for
increasing the effectiveness of the
Corporation’s programs and operations,
and for defining the unique role that
national service can play in building a
culture of citizenship, service, and
responsibility in America. A link to the
full text of the Strategic Plan and related
documents may be found under the
‘‘About Us’’ column at the following
Web site: https://
www.nationalservice.gov/.
Chief elements of the plan include:
• Revised Mission Statement. The
Corporation’s revised mission statement
reads, ‘‘Improve lives, strengthen
communities, and foster civic
engagement through service and
volunteering.’’
• Statement of Guiding Principles.
The plan articulates 10 principles,
including putting the needs of local
communities first and strengthening the
public-private partnerships that
underpin all of our programs.
• Identification of Five Focus Areas.
The plan identities four focus areas
where the Corporation intends to make
a significant difference in the next five
years: (1) Mobilizing More Volunteers;
(2) Ensuring a Brighter Future for All of
America’s Youth; (3) Engaging Students
in Communities; (4) Harnessing Baby
Boomers’ Experience; and (5) Directing
resources to address disaster relief and
preparedness. Each focus area requires
that the Corporation’s programs and
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common objectives and measurable
targets.
• Blueprint for Managerial
Excellence. The plan outlines ways to
create and foster shared values that
strengthen service delivery and ensure
workforce accountability.
If your organization is interested in
working with the Corporation in
achieving its goals, you are encouraged
to submit a collaboration proposal that
is tied to the Corporation’s Strategic
Plan, strategic goals, and related
programs and initiatives.
Dated: July 24, 2007.
David Eisner,
Chief Executive Officer.
[FR Doc. E7–14653 Filed 7–27–07; 8:45 am]
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DEPARTMENT OF DEFENSE
Office of the Secretary
Expansion of a TRICARE
Demonstration Project for the State of
Alaska
Department of Defense.
Notice of expansion of a
TRICARE demonstration project for the
State of Alaska.
AGENCY:
ACTION:
SUMMARY: This notice is to advise
interested parties of an expansion of a
Military Health System (MHS)
demonstration project entitled TRICARE
Provider Reimbursement Demonstration
Project for the State of Alaska. The
original demonstration notice was
published on November 20, 2006 (71 FR
67112–67113) and described a
demonstration project to increase
reimbursement for individual providers
in the State of Alaska. The
demonstration project will now also
include increased reimbursement for
health care services by hospitals that
have been designated as Critical Access
Hospitals (CAH) in the State of Alaska.
TRICARE, under the demonstration
project, will reimburse CAHs in a
similar manner as they are reimbursed
under Medicare. The expansion of the
demonstration project will test the effect
of this change on CAH provider
participation in TRICARE, beneficiary
access to care, cost of health care
services, military medical readiness,
morale and welfare. In particular, the
demonstration will test whether the
increased costs of provider payments
are offset in whole or part by savings in
travel costs, lost duty time, and other
factors. This demonstration will be
conducted under statutory authority
provided in 10 U.S.C. 1092.
DATES: Effective Date: The expansion of
the demonstration will be effective July
1, 2007, and will continue for a period
of 3 years from the date of the original
demonstration.
ADDRESSES: TRICARE Management
Activity (TMA), Medical Benefits and
Reimbursement Systems (MB&RS),
16401 E. Centretech Parkway, Aurora,
CO 80011.
FOR FURTHER INFORMATION CONTACT: For
questions pertaining to the expansion of
the demonstration/Critical Access
Hospital portion of the demonstration,
Ann N. Fazzini, 303.676.3803.
SUPPLEMENTARY INFORMATION:
A. Background
For additional information on the
TRICARE demonstration project for the
State of Alaska, please see 71 FR 67112–
67113. The demonstration notice
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Fmt 4703
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41501
focused on increased payment rates for
individual providers to determine the
impact on access to care.
This expansion of the demonstration
applies to Critical Access Hospitals
(CAH) within the State of Alaska.
Hospitals are authorized TRICARE
institutional providers under 10 U.S.C.
1079(j)(2) and (4). Under 10 U.S.C.
1079(j)(2), the amount to be paid to
hospitals, skilled nursing facilities
(SNFs), and other institutional providers
under TRICARE, shall, by regulation,
‘‘shall be determined to the extent
practicable in accordance with the same
reimbursement rules as apply to
payments to providers of services of the
same type under Medicare.’’ Under 32
CFR 199.14(a)(1)(ii)(D)(1) through (9) it
specifically lists those hospitals that are
exempt from the DRG-based payment
system. Critical access hospitals are not
listed as excluded, thereby making them
subject to the DRG-based payment
system. Critical access hospitals are not
listed as exempt, because at the time
this regulatory provision was written,
CAHs were not a recognized entity.
Legislation enacted as part of the
Balanced Budget Act (BBA) of 1997
authorized states to establish State
Medicare Rural Hospital Flexibility
Programs, under which certain facilities
participating in Medicare could become
Critical Access Hospitals (CAHs). CAHs
represent a separate provider type with
their own Medicare conditions of
participation as well as a separate
payment method. Since that time, a
number of hospitals have taken the
necessary steps to be designated as
CAHs. Since the statutory authority
requires TRICARE to apply the same
reimbursement rules as apply to
payments to providers of services of the
same type under Medicare to the extent
practicable, TRICARE has the authority
through the publication of a proposed
and final rule to exempt critical access
hospitals from the DRG-based payment
system and adopt a method similar to
Medicare principles for these hospitals.
The purpose of the demonstration is to
provide this exemption immediately to
CAHs in the State of Alaska.
Currently under TRICARE, CAHs are
subject to the TRICARE DRG-based
payment system. Under the
demonstration project, CAHs will be
reimbursed under a manner similar to
the Centers for Medicare and Medicaid
Services (CMS) payment methodology
of 101 percent of reasonable costs for
inpatient care and outpatient care.
CAHs in the State of Alaska are
currently receiving reimbursement for
billed charges for facility charges for
outpatient care. Under the
demonstration, the 101% of reasonable
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41502
Federal Register / Vol. 72, No. 145 / Monday, July 30, 2007 / Notices
costs will be calculated by multiplying
the billed charge of each claim by the
hospital’s cost-to-charge ratio, and then
adding 1% to that amount.
B. Current Status of Access
CAH providers in Alaska have
notified the Department that they are
considering no longer treating military
beneficiaries due to low payment rates.
The alternatives to local purchase of
services for military officials are to
transport patients to Seattle or another
location for treatment, or to relocate
scarce military medical assets to Alaska
to provide services. The first is an
expensive proposition that brings with
it considerable lost duty time and other
complications; the second approach is
untenable in wartime, and as a practical
matter medical practice in Alaska would
not provide sufficient opportunity for
military medical specialists to maintain
their skills.
C. Description of Expansion of
Demonstration Project
Under this demonstration, DoD will
also waive, for services provided in the
State of Alaska, the provisions of 10
U.S.C. 1079(j)(2), as implemented by 32
CFR 199.14(a) that do not exempt CAH
providers from the Medicare Diagnostic
Related Group payment methodology
for inpatient services. Instead, CAHs
will be reimbursed under the Centers for
Medicare and Medicaid Services (CMS)
payment methodology of 101 percent of
reasonable costs for inpatient care and
outpatient care.
This action will directly increase
overall reimbursement levels for CAH
providers, and is expected to result in
increased access to care for military
beneficiaries; reduced travel to Seattle,
accompanied by a reduction in lost duty
days; and improved morale for military
members and families as a result of
increased access and reduced
separation.
D. Implementation
The expansion of the demonstration
will be effective for inpatient
admissions on and after July 1, 2007 and
for outpatient services provided on and
after July 1, 2007.
mstockstill on PROD1PC66 with NOTICES
E. Evaluation
An independent evaluation of the
demonstration will be conducted. The
evaluation will be designed to use a
combination of administrative and
survey measures of health care access to
provide analyses and comment on the
effectiveness of the demonstration in
meeting its goal of improving
beneficiary access to healthcare by
VerDate Aug<31>2005
22:24 Jul 27, 2007
Jkt 211001
maximizing the potential pool of
healthcare providers in Alaska.
Dated: July 24, 2007.
L.M. Bynum,
Alternate OSD Federal Register Liaison
Officer, DoD.
[FR Doc. E7–14681 Filed 7–27–07; 8:45 am]
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DEPARTMENT OF DEFENSE
Office of the Secretary
Defense Science Board
Department of Defense.
Notice of Advisory Committee
Meetings.
AGENCY:
ACTION:
SUMMARY: The Defense Science Board
Task Force on Developmental Test and
Evaluation will meet in closed session
on August 22–23, 2007 and September
19–20, 2007 at Science Applications
International Corporation (SAIC), 4001
N. Fairfax Drive, Arlington, VA. These
meetings will examine Test &
Evaluation roles and responsibilities,
policy and practices, and recommend
changes that may contribute to
improved success in Initial Operational
Test and Evaluation along with quicker
delivery of improved capability and
sustainability to Warfighters.
The mission of the Defense Science
Board is to advise the Secretary of
Defense and the Under Secretary of
Defense for Acquisition, Technology &
Logistics on scientific and technical
matters as they affect the perceived
needs of the Department of Defense. At
these meetings, the Defense Science
Board Task Force will assess: OSD
organization roles and responsibilities
for T&E oversight; changes required to
establish statutory authority for OSD
DT&E oversight, and recommend
improvements in the DT&E process to
discover sustainability problems earlier,
and thus improve likelihood of
operational sustainability in IOT&E.
The task force’s findings and
recommendations, pursuant to 41 CFR
102–3.140 through 102–3.165, will be
presented and discussed by the
membership of the Defense Science
Board prior to being presented to the
Government’s decisionmaker.
Pursuant to 41 CFR 102–3.120 and
102–3.150, the Designated Federal
Officer for the Defense Science Board
will determine and announce in the
Federal Register when the findings and
recommendations of the May 31, 2007
meeting are deliberated by the Defense
Science Board.
Interested persons may submit a
written statement for consideration by
PO 00000
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Sfmt 4703
the Defense Science Board. Individuals
submitting a written statement must
submit their statement to the Designated
Federal Official at the address detailed
below, at any point, however, if a
written statement is not received at least
10 calendar days prior to the meeting,
which is the subject of this notice, then
it may not be provided to or considered
by the Defense Science Board. The
Designated Federal Official will review
all timely submissions with the Defense
Science Board Chairperson, and ensure
they are provided to members of the
Defense Science Board before the
meeting that is the subject of this notice.
FOR FURTHER INFORMATION CONTACT: MAJ
Chad Lominac, USAF, Defense Science
Board, 3140 Defense Pentagon, Room
3C553, Washington, DC 20301–3140, via
e-mail at charles.lominac@osd.mil, or
via phone at (703) 571–0081.
Dated: July 23, 2007.
L.M. Bynum,
OSD Federal Register, Liaison Officer,
Department of Defense.
[FR Doc. 07–3700 Filed 7–27–07; 8:45 am]
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DEPARTMENT OF DEFENSE
Office of the Secretary
Defense Science Board
Department of Defense.
Notice of Advisory Committee
Meetings.
AGENCY:
ACTION:
SUMMARY: The Defense Science Board
Task Force on Defense Industrial
Structure for Transformation will meet
in closed session on August 14, 2007, at
Science Applications International
Corporation (SAIC), 4001 N. Fairfax
Drive, Arlington, VA. This meeting will
characterize the degree of changed
needed in industry due to the changing
nature of DoD and the industrial Base.
It will also examine the effectiveness of
existing mitigation measures and make
recommendations to ensure future
competition and innovation throughout
all tiers of the defense industrial base.
The briefing will contain proprietary
material and ensuing discussions will
be at the collateral secret level.
The mission of the Defense Science
Board is to advise the Secretary of
Defense and the Under Secretary of
Defense for Acquisition, Technology &
Logistics on scientific and technical
matters as they affect the perceived
needs of the Department of Defense. At
the meeting, the Defense Science Board
Task Force will: describe the defense
industry required to cope with the
international security environment in
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Agencies
[Federal Register Volume 72, Number 145 (Monday, July 30, 2007)]
[Notices]
[Pages 41501-41502]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-14681]
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DEPARTMENT OF DEFENSE
Office of the Secretary
Expansion of a TRICARE Demonstration Project for the State of
Alaska
AGENCY: Department of Defense.
ACTION: Notice of expansion of a TRICARE demonstration project for the
State of Alaska.
-----------------------------------------------------------------------
SUMMARY: This notice is to advise interested parties of an expansion of
a Military Health System (MHS) demonstration project entitled TRICARE
Provider Reimbursement Demonstration Project for the State of Alaska.
The original demonstration notice was published on November 20, 2006
(71 FR 67112-67113) and described a demonstration project to increase
reimbursement for individual providers in the State of Alaska. The
demonstration project will now also include increased reimbursement for
health care services by hospitals that have been designated as Critical
Access Hospitals (CAH) in the State of Alaska. TRICARE, under the
demonstration project, will reimburse CAHs in a similar manner as they
are reimbursed under Medicare. The expansion of the demonstration
project will test the effect of this change on CAH provider
participation in TRICARE, beneficiary access to care, cost of health
care services, military medical readiness, morale and welfare. In
particular, the demonstration will test whether the increased costs of
provider payments are offset in whole or part by savings in travel
costs, lost duty time, and other factors. This demonstration will be
conducted under statutory authority provided in 10 U.S.C. 1092.
DATES: Effective Date: The expansion of the demonstration will be
effective July 1, 2007, and will continue for a period of 3 years from
the date of the original demonstration.
ADDRESSES: TRICARE Management Activity (TMA), Medical Benefits and
Reimbursement Systems (MB&RS), 16401 E. Centretech Parkway, Aurora, CO
80011.
FOR FURTHER INFORMATION CONTACT: For questions pertaining to the
expansion of the demonstration/Critical Access Hospital portion of the
demonstration, Ann N. Fazzini, 303.676.3803.
SUPPLEMENTARY INFORMATION:
A. Background
For additional information on the TRICARE demonstration project for
the State of Alaska, please see 71 FR 67112-67113. The demonstration
notice focused on increased payment rates for individual providers to
determine the impact on access to care.
This expansion of the demonstration applies to Critical Access
Hospitals (CAH) within the State of Alaska. Hospitals are authorized
TRICARE institutional providers under 10 U.S.C. 1079(j)(2) and (4).
Under 10 U.S.C. 1079(j)(2), the amount to be paid to hospitals, skilled
nursing facilities (SNFs), and other institutional providers under
TRICARE, shall, by regulation, ``shall be determined to the extent
practicable in accordance with the same reimbursement rules as apply to
payments to providers of services of the same type under Medicare.''
Under 32 CFR 199.14(a)(1)(ii)(D)(1) through (9) it specifically lists
those hospitals that are exempt from the DRG-based payment system.
Critical access hospitals are not listed as excluded, thereby making
them subject to the DRG-based payment system. Critical access hospitals
are not listed as exempt, because at the time this regulatory provision
was written, CAHs were not a recognized entity.
Legislation enacted as part of the Balanced Budget Act (BBA) of
1997 authorized states to establish State Medicare Rural Hospital
Flexibility Programs, under which certain facilities participating in
Medicare could become Critical Access Hospitals (CAHs). CAHs represent
a separate provider type with their own Medicare conditions of
participation as well as a separate payment method. Since that time, a
number of hospitals have taken the necessary steps to be designated as
CAHs. Since the statutory authority requires TRICARE to apply the same
reimbursement rules as apply to payments to providers of services of
the same type under Medicare to the extent practicable, TRICARE has the
authority through the publication of a proposed and final rule to
exempt critical access hospitals from the DRG-based payment system and
adopt a method similar to Medicare principles for these hospitals. The
purpose of the demonstration is to provide this exemption immediately
to CAHs in the State of Alaska.
Currently under TRICARE, CAHs are subject to the TRICARE DRG-based
payment system. Under the demonstration project, CAHs will be
reimbursed under a manner similar to the Centers for Medicare and
Medicaid Services (CMS) payment methodology of 101 percent of
reasonable costs for inpatient care and outpatient care. CAHs in the
State of Alaska are currently receiving reimbursement for billed
charges for facility charges for outpatient care. Under the
demonstration, the 101% of reasonable
[[Page 41502]]
costs will be calculated by multiplying the billed charge of each claim
by the hospital's cost-to-charge ratio, and then adding 1% to that
amount.
B. Current Status of Access
CAH providers in Alaska have notified the Department that they are
considering no longer treating military beneficiaries due to low
payment rates. The alternatives to local purchase of services for
military officials are to transport patients to Seattle or another
location for treatment, or to relocate scarce military medical assets
to Alaska to provide services. The first is an expensive proposition
that brings with it considerable lost duty time and other
complications; the second approach is untenable in wartime, and as a
practical matter medical practice in Alaska would not provide
sufficient opportunity for military medical specialists to maintain
their skills.
C. Description of Expansion of Demonstration Project
Under this demonstration, DoD will also waive, for services
provided in the State of Alaska, the provisions of 10 U.S.C.
1079(j)(2), as implemented by 32 CFR 199.14(a) that do not exempt CAH
providers from the Medicare Diagnostic Related Group payment
methodology for inpatient services. Instead, CAHs will be reimbursed
under the Centers for Medicare and Medicaid Services (CMS) payment
methodology of 101 percent of reasonable costs for inpatient care and
outpatient care.
This action will directly increase overall reimbursement levels for
CAH providers, and is expected to result in increased access to care
for military beneficiaries; reduced travel to Seattle, accompanied by a
reduction in lost duty days; and improved morale for military members
and families as a result of increased access and reduced separation.
D. Implementation
The expansion of the demonstration will be effective for inpatient
admissions on and after July 1, 2007 and for outpatient services
provided on and after July 1, 2007.
E. Evaluation
An independent evaluation of the demonstration will be conducted.
The evaluation will be designed to use a combination of administrative
and survey measures of health care access to provide analyses and
comment on the effectiveness of the demonstration in meeting its goal
of improving beneficiary access to healthcare by maximizing the
potential pool of healthcare providers in Alaska.
Dated: July 24, 2007.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, DoD.
[FR Doc. E7-14681 Filed 7-27-07; 8:45 am]
BILLING CODE 5001-06-P