Reasonable Charges for Medical Care or Services; V3.14, 2014 Calendar Year Update and National Average Administrative Prescription Drug Charge Update, 76413-76414 [2013-29997]
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wreier-aviles on DSK5TPTVN1PROD with NOTICES
Federal Register / Vol. 78, No. 242 / Tuesday, December 17, 2013 / Notices
Golden Age Games, National Veterans
Creative Arts Festival, National Veterans
TEE Tournament, National Disabled
Veterans Winter Sports Clinic and the
National Veterans Summer Sports
Clinic. The data collected will be used
to plan, distribute and utilize resources
and to allocate clinical and
administrative support to patient
treatment services.
An agency may not conduct or
sponsor, and a person is not required to
respond to a collection of information
unless it displays a currently valid OMB
control number. The Federal Register
Notice with a 60-day comment period
soliciting comments on this collection
of information was published on
September 11, 2013, at pages 55777–
55778.
Affected Public: Individuals or
households.
Estimated Annual Burden:
a. VA Form 0924a, c, d and VA Form
2900–0925 (SF)—133.3 hours.
b. VA Form 0924n—2.8 hours.
c. VA Form 0924s—2.8 hours.
d. VA Form 0924t—1.25 hours.
e. VA Form 0925b—119 hours.
f. VA Form 0925d—167 hours.
g. VA Form 0926a, b, d, e, g, h—333
hours.
h. VA Form 0926j—67 hours.
i. VA Form 0927a, c, e—65 hours.
j. VA Form 0927f—8 hours.
k. VA Form 0928a, c—14 hours.
l. VA Form 0928h—2.58 hours.
m. VA Form 0928i—.50 hours.
n. VA Form 0928j—1.33 hours.
o. VA0929a, b, c, d, e, f, g, h—116.6
hours.
Estimated Average Burden per
Respondent:
a. VA Form 0924a, c, d and VA Form
2900–0925 (SF)—20 minutes.
b. VA Form 0924n—5 minutes.
c. VA Form 0924s—5 minutes.
d. VA Form 0924t—5 minutes.
e. VA Form 0925b—10 minutes.
f. VA Form 0925d—5 minutes.
g. VA Form 0926a, b, d, e, g, h—20
minutes.
h. VA Form 0926j—5 minutes.
i. VA Form 0927a, c, e—13 minutes.
j. VA Form 0927f—5 minutes.
k. VA Form 0928a, c—7 minutes.
l. VA Form 0928h—5 minutes.
m. VA Form 0928i—5 minutes.
n. VA Form 0928j—5 minutes.
o. VA0929a, b, c, d, e, f, g, h—35
minutes.
Frequency of Response: On occasion.
Estimated Number of Respondents:
a. VA Form 0924a, c, d and VA Form
2900–0925 (SF)—400.
b. VA Form 0924n—25.
c. VA Form 0924s—200.
d. VA Form 0924t—15.
e. VA Form 0925b—715.
VerDate Mar<15>2010
14:45 Dec 16, 2013
Jkt 232001
f. VA Form 0925d—2,000.
g. VA Form 0926a, b, d, e, g, h—1,000.
h. VA Form 0926j—800.
i. VA Form 0927a, c, e—300.
j. VA Form 0927f—100.
k. VA Form 0928a, c—120.
l. VA Form 0928h—31.
m. VA Form 0928i—6.
n. VA Form 0928j—16.
o. VA0929a, b, c, d, e, f, g, h—200.
Dated: December 11, 2013.
By direction of the Secretary.
Crystal Rennie,
VA Clearance Officer, Department of Veterans
Affairs.
[FR Doc. 2013–29831 Filed 12–16–13; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
Reasonable Charges for Medical Care
or Services; V3.14, 2014 Calendar Year
Update and National Average
Administrative Prescription Drug
Charge Update
Department of Veterans Affairs.
Notice.
AGENCY:
ACTION:
This Department of Veterans
Affairs (VA) notice informs the public of
the updated data for calculating the
‘‘Reasonable Charges’’ collected or
recovered by VA for medical care or
services and the updated ‘‘National
Average Administrative Costs’’ for
purposes of calculating VA’s charges for
prescription drugs that were not
administered during treatment but
provided or furnished by VA to a
veteran for: (1) A nonservice-connected
disability for which the veteran is
entitled to care or the payment of
expenses for care under a health plan
contract; (2) 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 (3) a nonservice-connected
disability incurred as a result of a motor
vehicle accident in a state that requires
automobile accident reparations
insurance. The charge tables and
supplemental tables that are applicable
to this notice can be viewed on the
Veterans Health Administration Chief
Business Office’s Internet Web site
https://www1.va.gov/CBO/apps/rates/
index.asp. These changes are effective
January 1, 2014.
FOR FURTHER INFORMATION CONTACT:
Romona Greene, Chief Business Office
10NB, Veterans Health Administration,
Department of Veterans Affairs, 810
Vermont Avenue NW., Washington, DC
SUMMARY:
PO 00000
Frm 00145
Fmt 4703
Sfmt 4703
76413
20420, (202) 382–2521. This is not a toll
free number.
SUPPLEMENTARY INFORMATION: VA has
published regulations at 38 CFR 17.101
addressing ‘‘Reasonable Charges’’ for
medical care or services provided or
furnished by VA to a veteran for: (1) A
nonservice-connected disability for
which the veteran is entitled to care (or
the payment of expenses for care) under
a health plan contract; (2) a nonserviceconnected 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 (3) a
nonservice-connected disability
incurred as a result of a motor vehicle
accident in a state that requires
automobile accident reparations
insurance.
The regulation at 38 CFR 17.101
includes methodologies for establishing
billed amounts for the following types
of charges: acute inpatient facility
charges; skilled nursing facility and subacute 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. In cases
where VA has not established charges
for medical care or services provided or
furnished at VA expense (by either VA
or non-VA providers) under other
provisions or regulations, the method
for determining VA’s charges is set forth
at 38 CFR 17.101(a)(8).
The regulation provides that the
actual charge amounts at individual VA
facilities based on these methodologies
and the data sources used for
calculating those actual charge amounts
will either be published as a notice in
the Federal Register or will be posted
on the Internet site of the Veterans
Health Administration Chief Business
Office at https://www1.va.gov/CBO/apps/
rates/index.asp. Certain charges are
hereby updated as described below,
effective January 1, 2014.
Based on the methodologies set forth
in 38 CFR 17.101, this document
provides an update to charges for 2014
HCPCS Level II and Current Procedural
Technology (CPT) codes. Charges are
also being updated based on more
E:\FR\FM\17DEN1.SGM
17DEN1
76414
Federal Register / Vol. 78, No. 242 / Tuesday, December 17, 2013 / Notices
wreier-aviles on DSK5TPTVN1PROD with NOTICES
recent versions of data sources for the
following charge types: 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 updated
charges are effective January 1, 2014. As
of the date of this notice, the actual
charge amounts at individual VA
facilities based on the methodologies in
the regulation will be posted at https://
www1.va.gov/CBO/apps/rates/
index.asp, under the heading
‘‘Reasonable Charges Data Tables’’ and
identified as ‘‘V3.14 Data Tables
(Outpatient and Professional).’’
The list of data sources used for
calculating the actual charge amounts
will be posted at https://www1.va.gov/
CBO/apps/rate/index.asp under the
heading ‘‘Reasonable Charges Data
Sources’’ and identified as ‘‘Reasonable
Charges V3.14 Data Sources (Outpatient
and Professional) (PDF).’’
Acute inpatient facility charges and
skilled nursing facility/sub-acute
inpatient facility charges remain the
same as set forth in the notice published
in the Federal Register on September
26, 2013 (78 FR 59427). The effective
date of those charges was October 1,
2013. The data tables containing those
actual charges are posted at https://
www1.va.gov/CBO/apps/rates/
index.asp, under the heading
‘‘Reasonable Charges Data Tables’’ and
identified as ‘‘V3.13 Data Tables
(Inpatient).’’ The data sources used to
VerDate Mar<15>2010
14:45 Dec 16, 2013
Jkt 232001
calculate these charges are posted at
https://www1.va.gov/CBO/apps/rate/
index.asp under the heading
‘‘Reasonable Charges Data Sources’’ and
identified as ‘‘Reasonable Charges V3.13
Data Sources (Inpatient) (PDF).’’
We have also updated the list of VA
medical facility locations. The list of VA
medical facility locations, including the
first three digits of their zip codes as
well as provider based/non-provider
based designations, will be posted on
the Internet site of the Veterans Health
Administration Chief Business Office,
currently at https://www1.va.gov/CBO/
apps/rate/index.asp under the heading
‘‘VA Medical Facility Locations,’’ and
identified as ‘‘VA Medical Facility
Locations V3.14 (Jan14).’’
As provided in 38 CFR 17.101(m),
when VA provides or furnishes
prescription drugs not administered
during treatment, ‘‘charges billed
separately for such prescription drugs
will consist of the amount that equals
the total of the actual cost to VA for the
drugs and the national average of VA
administrative costs associated with
dispensing the drugs for each
prescription.’’
Section 17.101(m) includes the
methodology for calculating the national
average administrative cost for
prescription drug charges not
administered during treatment. The
administrative cost is determined
annually using VA’s managerial cost
accounting system. Under this
accounting system, the national average
administrative cost is determined by
adding the total VA national drug
general overhead costs (such as costs of
buildings and maintenance, utilities,
billing, and collections) to the total VA
national drug dispensing costs (such as
costs of the labor of the pharmacy
department, packaging, and mailing)
PO 00000
Frm 00146
Fmt 4703
Sfmt 9990
with the sum divided by the actual
number of VA prescriptions filled
nationally. The labor cost also includes
cost for the professional activity of
reviewing and dispensing a
prescription.
Based on the accounting system, VA
will determine the amount of the
national average administrative cost
annually for the prior fiscal year
(October through September) and then
apply the charge at the start of the next
calendar year. The national average
administrative drug cost for the calendar
year (CY) 2014 is $13.07. This change is
effective on January 1, 2014, and will be
posted at https://www1.va.gov/CBO/
payerinfo.asp and identified as ‘‘CY
2014 Average Administrative Cost for
Prescriptions.’’
Consistent with the regulations, the
national average administrative cost, the
updated data tables, and supplementary
tables containing the changes described
in this notice will be posted online, as
indicated in this notice. This notice will
be posted at https://www1.va.gov/CBO/
apps/rates/index.asp under the heading
‘‘Federal Registers, Rules, and Notices’’
and identified as, ‘‘V3.14 Federal
Register Notice 01/01/14 (Outpatient
and Professional), and National
Administrative Cost (PDF).’’ The
national average administrative cost,
updated data tables, and the
supplementary tables containing the
changes described will be effective until
changed by a subsequent Federal
Register notice.
Approved: December 9, 2013.
Jose D. Riojas,
Chief of Staff, Department of Veterans Affairs.
[FR Doc. 2013–29997 Filed 12–16–13; 8:45 am]
BILLING CODE 8320–01–P
E:\FR\FM\17DEN1.SGM
17DEN1
]]>Agencies
[Federal Register Volume 78, Number 242 (Tuesday, December 17, 2013)]
[Notices]
[Pages 76413-76414]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-29997]
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
Reasonable Charges for Medical Care or Services; V3.14, 2014
Calendar Year Update and National Average Administrative Prescription
Drug Charge Update
AGENCY: Department of Veterans Affairs.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This Department of Veterans Affairs (VA) notice informs the
public of the updated data for calculating the ``Reasonable Charges''
collected or recovered by VA for medical care or services and the
updated ``National Average Administrative Costs'' for purposes of
calculating VA's charges for prescription drugs that were not
administered during treatment but provided or furnished by VA to a
veteran for: (1) A nonservice-connected disability for which the
veteran is entitled to care or the payment of expenses for care under a
health plan contract; (2) 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 (3) a nonservice-connected disability
incurred as a result of a motor vehicle accident in a state that
requires automobile accident reparations insurance. The charge tables
and supplemental tables that are applicable to this notice can be
viewed on the Veterans Health Administration Chief Business Office's
Internet Web site https://www1.va.gov/CBO/apps/rates/index.asp. These
changes are effective January 1, 2014.
FOR FURTHER INFORMATION CONTACT: Romona Greene, Chief Business Office
10NB, Veterans Health Administration, Department of Veterans Affairs,
810 Vermont Avenue NW., Washington, DC 20420, (202) 382-2521. This is
not a toll free number.
SUPPLEMENTARY INFORMATION: VA has published regulations at 38 CFR
17.101 addressing ``Reasonable Charges'' for medical care or services
provided or furnished by VA to a veteran for: (1) A nonservice-
connected disability for which the veteran is entitled to care (or the
payment of expenses for care) under a health plan contract; (2) 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 (3) a nonservice-connected disability incurred as a result of a
motor vehicle accident in a state that requires automobile accident
reparations insurance.
The regulation at 38 CFR 17.101 includes methodologies for
establishing billed amounts for the following types of charges: acute
inpatient facility charges; skilled nursing facility and 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. In cases where VA has
not established charges for medical care or services provided or
furnished at VA expense (by either VA or non-VA providers) under other
provisions or regulations, the method for determining VA's charges is
set forth at 38 CFR 17.101(a)(8).
The regulation provides that the actual charge amounts at
individual VA facilities based on these methodologies and the data
sources used for calculating those actual charge amounts will either be
published as a notice in the Federal Register or will be posted on the
Internet site of the Veterans Health Administration Chief Business
Office at https://www1.va.gov/CBO/apps/rates/index.asp. Certain charges
are hereby updated as described below, effective January 1, 2014.
Based on the methodologies set forth in 38 CFR 17.101, this
document provides an update to charges for 2014 HCPCS Level II and
Current Procedural Technology (CPT) codes. Charges are also being
updated based on more
[[Page 76414]]
recent versions of data sources for the following charge types: 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 updated charges are
effective January 1, 2014. As of the date of this notice, the actual
charge amounts at individual VA facilities based on the methodologies
in the regulation will be posted at https://www1.va.gov/CBO/apps/rates/index.asp, under the heading ``Reasonable Charges Data Tables'' and
identified as ``V3.14 Data Tables (Outpatient and Professional).''
The list of data sources used for calculating the actual charge
amounts will be posted at https://www1.va.gov/CBO/apps/rate/index.asp
under the heading ``Reasonable Charges Data Sources'' and identified as
``Reasonable Charges V3.14 Data Sources (Outpatient and Professional)
(PDF).''
Acute inpatient facility charges and skilled nursing facility/sub-
acute inpatient facility charges remain the same as set forth in the
notice published in the Federal Register on September 26, 2013 (78 FR
59427). The effective date of those charges was October 1, 2013. The
data tables containing those actual charges are posted at https://www1.va.gov/CBO/apps/rates/index.asp, under the heading ``Reasonable
Charges Data Tables'' and identified as ``V3.13 Data Tables
(Inpatient).'' The data sources used to calculate these charges are
posted at https://www1.va.gov/CBO/apps/rate/index.asp under the heading
``Reasonable Charges Data Sources'' and identified as ``Reasonable
Charges V3.13 Data Sources (Inpatient) (PDF).''
We have also updated the list of VA medical facility locations. The
list of VA medical facility locations, including the first three digits
of their zip codes as well as provider based/non-provider based
designations, will be posted on the Internet site of the Veterans
Health Administration Chief Business Office, currently at https://www1.va.gov/CBO/apps/rate/index.asp under the heading ``VA Medical
Facility Locations,'' and identified as ``VA Medical Facility Locations
V3.14 (Jan14).''
As provided in 38 CFR 17.101(m), when VA provides or furnishes
prescription drugs not administered during treatment, ``charges billed
separately for such prescription drugs will consist of the amount that
equals the total of the actual cost to VA for the drugs and the
national average of VA administrative costs associated with dispensing
the drugs for each prescription.''
Section 17.101(m) includes the methodology for calculating the
national average administrative cost for prescription drug charges not
administered during treatment. The administrative cost is determined
annually using VA's managerial cost accounting system. Under this
accounting system, the national average administrative cost is
determined by adding the total VA national drug general overhead costs
(such as costs of buildings and maintenance, utilities, billing, and
collections) to the total VA national drug dispensing costs (such as
costs of the labor of the pharmacy department, packaging, and mailing)
with the sum divided by the actual number of VA prescriptions filled
nationally. The labor cost also includes cost for the professional
activity of reviewing and dispensing a prescription.
Based on the accounting system, VA will determine the amount of the
national average administrative cost annually for the prior fiscal year
(October through September) and then apply the charge at the start of
the next calendar year. The national average administrative drug cost
for the calendar year (CY) 2014 is $13.07. This change is effective on
January 1, 2014, and will be posted at https://www1.va.gov/CBO/payerinfo.asp and identified as ``CY 2014 Average Administrative Cost
for Prescriptions.''
Consistent with the regulations, the national average
administrative cost, the updated data tables, and supplementary tables
containing the changes described in this notice will be posted online,
as indicated in this notice. This notice will be posted at https://www1.va.gov/CBO/apps/rates/index.asp under the heading ``Federal
Registers, Rules, and Notices'' and identified as, ``V3.14 Federal
Register Notice 01/01/14 (Outpatient and Professional), and National
Administrative Cost (PDF).'' The national average administrative cost,
updated data tables, and the supplementary tables containing the
changes described will be effective until changed by a subsequent
Federal Register notice.
Approved: December 9, 2013.
Jose D. Riojas,
Chief of Staff, Department of Veterans Affairs.
[FR Doc. 2013-29997 Filed 12-16-13; 8:45 am]
BILLING CODE 8320-01-P
