Reasonable Charges for Inpatient MS-DRGs and SNF Medical Services; V3.8, 2012 Fiscal Year Update, 60136-60137 [2011-24946]

Download as PDF 60136 Federal Register / Vol. 76, No. 188 / Wednesday, September 28, 2011 / Notices times are changed, hearing requests withdrawn and new hearings requested after failure to appear at a scheduled hearing. The information is used to comply with the appellants’ or their representatives’ requests. d. Motions for Reconsideration: Decisions by BVA are final unless the Chairman orders reconsideration of the decision either on the Chairman’s initiative, or upon motion of a claimant. The Board Chairman, or his designee, uses the information provided in deciding whether reconsideration of a Board decision should be granted. Affected Public: Individuals or households, Business or other for profit, and Not for profit institutions. Estimated Total Annual Burden: a. Appeal to Board of Veterans’ Appeals, VA Form 9—45,850 hours. b. Withdrawal of Services by a Representative—183 hours. c. Request for Changes in Hearing Date—1,212 hours. d. Motions for Reconsideration—846 hours. Estimated Average Burden per Respondent: a. Appeal to Board of Veterans’ Appeals, VA Form 9—1 hour. b. Withdrawal of Services by a Representative—20 minutes. c. Request for Changes in Hearing Date—15 minutes (hearing date change), 15 minutes (request to withdraw a hearing),—1 hour (requests change a motion). d. Motions for Reconsideration—1 hour. Frequency of Response: On occasion. Estimated Total Number of Respondents: a. Appeal to Board of Veterans’ Appeals, VA Form 9—45,850. b. Withdrawal of Services by a Representative—550. c. Request for Changes in Hearing Date—2,733. d. Motions for Reconsideration—846. Dated: September 22, 2011. By direction of the Secretary. Denise McLamb, Program Analyst, Enterprise Records Service. [FR Doc. 2011–24830 Filed 9–27–11; 8:45 am] October 17–18, 2011, at the Department of Veterans Affairs Regional Office, 245 West Houston Street, Manhattan, New York, from 8:30 a.m. to 3:30 p.m. The meeting is open to the public. The purpose of the Committee is to advise the Secretary of Veterans Affairs on the maintenance and periodic readjustment of the VA Schedule for Rating Disabilities. The Committee is to assemble and review relevant information relating to the nature and character of disabilities arising from service in the Armed Forces, provide an ongoing assessment of the effectiveness of the rating schedule, and give advice on the most appropriate means of responding to the needs of Veterans relating to disability compensation. The Committee will receive briefings on issues related to compensation for Veterans with service-connected disabilities and other VA benefits programs. Time will be allocated for receiving public comments in the afternoon. Public comments will be limited to three minutes each. Individuals wishing to make oral statements before the Committee will be accommodated on a first-come, firstserved basis. Individuals who speak are invited to submit 1–2 page summaries of their comments at the time of the meeting for inclusion in the official meeting record. The public may submit written statements for the Committee’s review to Robert Watkins, Designated Federal Officer, Department of Veterans Affairs, Veterans Benefits Administration, Compensation and Pension Service, Regulation Staff (211D), 810 Vermont Avenue, NW., Washington, DC 20420, or e-mail at Robert.Watkins2@va.gov. Any member of the public wishing to attend the meeting or seeking additional information should contact Mr. Watkins at (202) 461–9214 Dated: September 22, 2011. By Direction of the Secretary. Vivian Drake, Acting Committee Management Officer. [FR Doc. 2011–24872 Filed 9–27–11; 8:45 am] BILLING CODE 8320–01–P BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS sroberts on DSK5SPTVN1PROD with NOTICES DEPARTMENT OF VETERANS AFFAIRS Reasonable Charges for Inpatient MS– DRGs and SNF Medical Services; V3.8, 2012 Fiscal Year Update Advisory Committee on Disability Compensation, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92– 463 (Federal Advisory Committee Act) that the Advisory Committee on Disability Compensation will meet on VerDate Mar<15>2010 18:20 Sep 27, 2011 Jkt 223001 Department of Veterans Affairs. Notice. AGENCY: ACTION: Section 17.101 of Title 38 of the Code of Federal Regulations sets forth the Department of Veterans Affairs SUMMARY: PO 00000 Frm 00140 Fmt 4703 Sfmt 4703 (VA) medical regulations concerning ‘‘Reasonable Charges’’ for medical care or services provided or furnished by VA to a veteran: —For a nonservice-connected disability for which the veteran is entitled to care (or the payment of expenses of care) under a health plan contract; —For a nonservice-connected disability incurred incident to the veteran’s employment and covered under a worker’s compensation law or plan that provides reimbursement or indemnification for such care and services; or —For a nonservice-connected disability incurred as a result of a motor vehicle accident in a State that requires automobile accident reparations insurance. The regulations include methodologies for establishing billed amounts for the following types of charges: acute inpatient facility charges; skilled nursing facility/sub-acute inpatient facility charges; partial hospitalization facility charges; outpatient facility charges; physician and other professional charges, including professional charges for anesthesia services and dental services; pathology and laboratory charges; observation care facility charges; ambulance and other emergency transportation charges; and charges for durable medical equipment, drugs, injectables, and other medical services, items, and supplies identified by Healthcare Common Procedure Coding System (HCPCS) Level II codes. The regulations also provide that data for calculating actual charge amounts at individual VA facilities based on these methodologies will either be published in a notice in the Federal Register or will be posted on the Internet site of the Veterans Health Administration (VHA) Chief Business Office, currently at http://www1.va.gov/CBO/apps/rates/ index.asp, under ‘‘Reasonable Charges Data Sources.’’ Certain charges are hereby updated as described in the Supplementary Information section of this notice. These changes are effective October 1, 2011. When charges for medical care or services provided or furnished at VA expense by either VA or non-VA providers have not been established under other provisions of the regulations, the method for determining VA’s charges is set forth at 38 CFR 17.101(a)(8). FOR FURTHER INFORMATION CONTACT: Romona Greene, Chief Business Office (10NB1A), Veterans Health Administration, Department of Veterans Affairs, 810 Vermont Avenue, NW., E:\FR\FM\28SEN1.SGM 28SEN1 Federal Register / Vol. 76, No. 188 / Wednesday, September 28, 2011 / Notices Washington, DC 20420, (202) 461–1595. (This is not a toll free number.) Of the charge types listed in the Summary section of this notice, only the acute inpatient facility charges and skilled nursing facility/sub-acute inpatient facility charges are being changed. Charges are not being changed for: partial hospitalization facility charges; outpatient facility charges; physician and other professional charges, including professional charges for anesthesia services and dental services; pathology and laboratory charges; observation care facility charges; ambulance and other emergency transportation charges; and charges for durable medical equipment, drugs, injectables, and other medical services, items, and supplies identified by HCPCS Level II codes. These outpatient facility charges and professional charges remain the same as set forth in a notice published in the Federal Register on December 27, 2010 (75 FR 81335). Based on the methodologies set forth in 38 CFR 17.101(b), this document provides an update to acute inpatient charges that were based on 2011 Medicare severity diagnosis related groups (MS–DRGs). Acute inpatient facility charges by MS–DRGs are set forth in Table A and are posted on the Internet site of the VHA Chief Business Office, currently at http://www1.va.gov/ CBO/apps/rates/index.asp, under ‘‘Reasonable Charges Data Tables.’’ This Table A corresponds to the Table A referenced in the September 27, 2010, Federal Register Notice. Table A referenced in this notice provides updated charges based on 2012 MS– DRGs and will replace Table A posted on the Internet site of the VHA Chief Business Office, which corresponds to sroberts on DSK5SPTVN1PROD with NOTICES SUPPLEMENTARY INFORMATION: VerDate Mar<15>2010 18:20 Sep 27, 2011 Jkt 223001 the Table A referenced in the September 27, 2010, Federal Register notice. Also, this document provides for an updated all-inclusive per diem charge for skilled nursing facility/sub-acute inpatient facility charge using the methodologies set forth in 38 CFR 17.101(c), and it is adjusted by a geographic area factor based on the location where the care is provided (See Table ‘‘N’’ Acute Inpatient and Table ‘‘O’’ SNF geographic factors found on Web site under ‘‘Reasonable Charges Data Tables’’). The skilled nursing facility/sub-acute inpatient facility per diem charge is set forth in Table B and is posted on the Internet site of the VHA Chief Business Office, currently at http://www1.va.gov/CBO/apps/rates/ index.asp, under ‘‘Reasonable Charges Data Tables.’’ This Table B corresponds to the Table B referenced in the September 27, 2010, Federal Register Notice. Table B referenced in this notice provides updated all-inclusive nationwide skilled nursing facility/subacute inpatient facility per diem charge and will replace Table B posted on the Internet site of the VHA Chief Business Office, which corresponds to the Table B referenced in the September 27, 2010, Federal Register notice. The charges in this update for acute inpatient facility and skilled nursing facility/sub-acute inpatient facility services are effective October 1, 2011. In this update, we are retaining the table designations used for acute inpatient facility charges by MS–DRGs which is posted on the Internet site of the VHA Chief Business Office, currently at http://www1.va.gov/CBO/ apps/rates/index.asp, under ‘‘Reasonable Charges Data Tables.’’ We also are retaining the table designation used for skilled nursing facility/subacute inpatient facility charges which is PO 00000 Frm 00141 Fmt 4703 Sfmt 9990 60137 posted on the Internet site of the VHA Chief Business Office, currently at http://www1.va.gov/CBO/apps/rates/ index.asp, under ‘‘Reasonable Charges Data Tables.’’ Accordingly, the tables identified as being updated by this notice correspond to the applicable tables referenced in the September 27, 2010, notice, beginning with Table A through Table B. The list of data sources presented in Supplementary Table 1 will be posted on the Internet site of the VHA Chief Business Office, currently at http:// www1.va.gov/CBO/apps/rates/ index.asp, under ‘‘Reasonable Charges Data Sources’’ to reflect the updated data sources used to establish the updated charges described in this notice. We have also updated the list of VA medical facility locations. As a reminder, in Supplementary Table 3 posted on the internet site of the VHA Chief Business Office, currently at http://www1.va.gov/CBO/apps/rates/ index.asp, under ‘‘VA Medical Facility Locations,’’ we set forth the list of VA medical facility locations, which includes the first three digits of their ZIP Codes and provider-based/nonprovider-based designations. Consistent with VA’s regulations, the updated data tables and supplementary tables containing the changes described in this notice will be posted on the Internet site of the VHA Chief Business Office, ‘‘Reasonable Charges (Rates) Information’’ page currently at http:// www1.va.gov/CBO/apps/rates/ index.asp. Approved: September 22, 2011. John R. Gingrich, Chief of Staff, Department of Veterans Affairs. [FR Doc. 2011–24946 Filed 9–27–11; 8:45 am] BILLING CODE 8320–01–P E:\FR\FM\28SEN1.SGM 28SEN1

Agencies

[Federal Register Volume 76, Number 188 (Wednesday, September 28, 2011)]
[Notices]
[Pages 60136-60137]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-24946]


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DEPARTMENT OF VETERANS AFFAIRS


Reasonable Charges for Inpatient MS-DRGs and SNF Medical 
Services; V3.8, 2012 Fiscal Year Update

AGENCY: Department of Veterans Affairs.

ACTION: Notice.

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

SUMMARY: Section 17.101 of Title 38 of the Code of Federal Regulations 
sets forth the Department of Veterans Affairs (VA) medical regulations 
concerning ``Reasonable Charges'' for medical care or services provided 
or furnished by VA to a veteran:

--For a nonservice-connected disability for which the veteran is 
entitled to care (or the payment of expenses of care) under a health 
plan contract;
--For a nonservice-connected disability incurred incident to the 
veteran's employment and covered under a worker's compensation law or 
plan that provides reimbursement or indemnification for such care and 
services; or
--For a nonservice-connected disability incurred as a result of a motor 
vehicle accident in a State that requires automobile accident 
reparations insurance.

    The regulations include methodologies for establishing billed 
amounts for the following types of charges: acute inpatient facility 
charges; skilled nursing facility/sub-acute inpatient facility charges; 
partial hospitalization facility charges; outpatient facility charges; 
physician and other professional charges, including professional 
charges for anesthesia services and dental services; pathology and 
laboratory charges; observation care facility charges; ambulance and 
other emergency transportation charges; and charges for durable medical 
equipment, drugs, injectables, and other medical services, items, and 
supplies identified by Healthcare Common Procedure Coding System 
(HCPCS) Level II codes. The regulations also provide that data for 
calculating actual charge amounts at individual VA facilities based on 
these methodologies will either be published in a notice in the Federal 
Register or will be posted on the Internet site of the Veterans Health 
Administration (VHA) Chief Business Office, currently at http://www1.va.gov/CBO/apps/rates/index.asp, under ``Reasonable Charges Data 
Sources.'' Certain charges are hereby updated as described in the 
Supplementary Information section of this notice. These changes are 
effective October 1, 2011.
    When charges for medical care or services provided or furnished at 
VA expense by either VA or non-VA providers have not been established 
under other provisions of the regulations, the method for determining 
VA's charges is set forth at 38 CFR 17.101(a)(8).

FOR FURTHER INFORMATION CONTACT: Romona Greene, Chief Business Office 
(10NB1A), Veterans Health Administration, Department of Veterans 
Affairs, 810 Vermont Avenue, NW.,

[[Page 60137]]

Washington, DC 20420, (202) 461-1595. (This is not a toll free number.)

SUPPLEMENTARY INFORMATION: Of the charge types listed in the Summary 
section of this notice, only the acute inpatient facility charges and 
skilled nursing facility/sub-acute inpatient facility charges are being 
changed. Charges are not being changed for: partial hospitalization 
facility charges; outpatient facility charges; physician and other 
professional charges, including professional charges for anesthesia 
services and dental services; pathology and laboratory charges; 
observation care facility charges; ambulance and other emergency 
transportation charges; and charges for durable medical equipment, 
drugs, injectables, and other medical services, items, and supplies 
identified by HCPCS Level II codes. These outpatient facility charges 
and professional charges remain the same as set forth in a notice 
published in the Federal Register on December 27, 2010 (75 FR 81335).
    Based on the methodologies set forth in 38 CFR 17.101(b), this 
document provides an update to acute inpatient charges that were based 
on 2011 Medicare severity diagnosis related groups (MS-DRGs). Acute 
inpatient facility charges by MS-DRGs are set forth in Table A and are 
posted on the Internet site of the VHA Chief Business Office, currently 
at http://www1.va.gov/CBO/apps/rates/index.asp, under ``Reasonable 
Charges Data Tables.'' This Table A corresponds to the Table A 
referenced in the September 27, 2010, Federal Register Notice. Table A 
referenced in this notice provides updated charges based on 2012 MS-
DRGs and will replace Table A posted on the Internet site of the VHA 
Chief Business Office, which corresponds to the Table A referenced in 
the September 27, 2010, Federal Register notice.
    Also, this document provides for an updated all-inclusive per diem 
charge for skilled nursing facility/sub-acute inpatient facility charge 
using the methodologies set forth in 38 CFR 17.101(c), and it is 
adjusted by a geographic area factor based on the location where the 
care is provided (See Table ``N'' Acute Inpatient and Table ``O'' SNF 
geographic factors found on Web site under ``Reasonable Charges Data 
Tables''). The skilled nursing facility/sub-acute inpatient facility 
per diem charge is set forth in Table B and is posted on the Internet 
site of the VHA Chief Business Office, currently at http://www1.va.gov/CBO/apps/rates/index.asp, under ``Reasonable Charges Data Tables.'' 
This Table B corresponds to the Table B referenced in the September 27, 
2010, Federal Register Notice. Table B referenced in this notice 
provides updated all-inclusive nationwide skilled nursing facility/sub-
acute inpatient facility per diem charge and will replace Table B 
posted on the Internet site of the VHA Chief Business Office, which 
corresponds to the Table B referenced in the September 27, 2010, 
Federal Register notice.
    The charges in this update for acute inpatient facility and skilled 
nursing facility/sub-acute inpatient facility services are effective 
October 1, 2011.
    In this update, we are retaining the table designations used for 
acute inpatient facility charges by MS-DRGs which is posted on the 
Internet site of the VHA Chief Business Office, currently at http://www1.va.gov/CBO/apps/rates/index.asp, under ``Reasonable Charges Data 
Tables.'' We also are retaining the table designation used for skilled 
nursing facility/sub-acute inpatient facility charges which is posted 
on the Internet site of the VHA Chief Business Office, currently at 
http://www1.va.gov/CBO/apps/rates/index.asp, under ``Reasonable Charges 
Data Tables.'' Accordingly, the tables identified as being updated by 
this notice correspond to the applicable tables referenced in the 
September 27, 2010, notice, beginning with Table A through Table B.
    The list of data sources presented in Supplementary Table 1 will be 
posted on the Internet site of the VHA Chief Business Office, currently 
at http://www1.va.gov/CBO/apps/rates/index.asp, under ``Reasonable 
Charges Data Sources'' to reflect the updated data sources used to 
establish the updated charges described in this notice.
    We have also updated the list of VA medical facility locations. As 
a reminder, in Supplementary Table 3 posted on the internet site of the 
VHA Chief Business Office, currently at http://www1.va.gov/CBO/apps/rates/index.asp, under ``VA Medical Facility Locations,'' we set forth 
the list of VA medical facility locations, which includes the first 
three digits of their ZIP Codes and provider-based/non-provider-based 
designations.
    Consistent with VA's regulations, the updated data tables and 
supplementary tables containing the changes described in this notice 
will be posted on the Internet site of the VHA Chief Business Office, 
``Reasonable Charges (Rates) Information'' page currently at http://www1.va.gov/CBO/apps/rates/index.asp.

    Approved: September 22, 2011.
John R. Gingrich,
Chief of Staff, Department of Veterans Affairs.
[FR Doc. 2011-24946 Filed 9-27-11; 8:45 am]
BILLING CODE 8320-01-P