TRICARE, Formerly Known as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); Fiscal Year 2016 Mental Health Rate Updates, 65716-65717 [2015-27234]
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Federal Register / Vol. 80, No. 207 / Tuesday, October 27, 2015 / Notices
Administration and Management
Directorate, 16401 East Centretech
Parkway, Aurora, CO 80011–9066.’’
DEPARTMENT OF DEFENSE
NOTIFICATION PROCEDURE:
TRICARE, Formerly Known as the
Civilian Health and Medical Program of
the Uniformed Services (CHAMPUS);
Fiscal Year 2016 Mental Health Rate
Updates
Office of the Secretary
Delete entry and replace with
‘‘Individuals seeking to determine
whether information about themselves
is contained in this system of records
should address written inquiries to
Chief, Freedom of Information Act
(FOIA) Service Center, Defense Health
Agency Privacy and Civil Liberties
Office, 7700 Arlington Boulevard, Suite
5101, Falls Church, VA 22042–5101.
Requests should contain the full name
and signature of the sponsor or
beneficiary.
If requesting information about a
minor or legally incompetent person,
the request must be made by the
custodial parent, legal guardian, or party
acting in loco parentis of such
individual. Written proof of that status
may be required before the existence of
any information will be confirmed.’’
RECORD ACCESS PROCEDURES:
Delete entry and replace with
‘‘Individuals seeking access to records
about themselves contained in this
system of records should address
written inquiries to the Chief, FOIA
Service Center, Defense Health Agency
Privacy and Civil Liberties Office, 7700
Arlington Boulevard, Suite 5101, Falls
Church, VA 22042–5101.
Written requests for information
should include the full name and
signature of the sponsor or beneficiary.
If requesting records about a minor or
legally incompetent person, the request
must be made by the custodial parent,
legal guardian, or party acting in loco
parentis of such individual. Written
proof of that status may be required
before any records will be provided.’’
CONTESTING RECORD PROCEDURES:
Delete entry and replace with ‘‘The
Office of the Secretary of Defense (OSD)
rules for accessing records, for
contesting contents and appealing
initial agency determinations are
published in OSD Administrative
Instruction 81, 32 CFR part 311, or may
be obtained from the system manager.’’
tkelley on DSK3SPTVN1PROD with NOTICES
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Delete entry and replace with
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Beneficiary Counseling and Assistance
Coordinators, all branches of the
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consultants, sponsor and/or
beneficiary.’’
*
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*
*
*
[FR Doc. 2015–27229 Filed 10–26–15; 8:45 am]
BILLING CODE 5001–06–P
VerDate Sep<11>2014
19:58 Oct 26, 2015
Jkt 238001
Department of Defense.
Notice of Updated Mental
Health Rates for Fiscal Year 2016.
AGENCY:
ACTION:
This notice provides the
updated regional per-diem rates for lowvolume mental health providers; the
update factor for hospital-specific perdiems; the updated cap per-diem for
high-volume providers; the beneficiary
per-diem cost-share amount for lowvolume providers; and, the updated perdiem rates for both full-day and half-day
TRICARE Partial Hospitalization
Programs for Fiscal Year 2016.
DATES: Effective Date: The Fiscal Year
2016 rates contained in this notice are
effective for services on or after October
1, 2015.
ADDRESSES: Defense Health Agency
(DHA), Medical Benefits and
Reimbursement Section, 16401 East
Centretech Parkway, Aurora, CO 80011–
9066.
FOR FURTHER INFORMATION CONTACT: Elan
Green, Medical Benefits and
Reimbursement Section, DHA,
telephone (303) 676–3907.
SUPPLEMENTARY INFORMATION: The final
rule published in the Federal Register
(FR) on September 6, 1988 (53 FR
34285) set forth reimbursement changes
that were effective for all inpatient
hospital admissions in psychiatric
hospitals and exempt psychiatric units
occurring on or after January 1, 1989.
The final rule published in the Federal
Register on July 1, 1993 (58 FR 35–400)
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 (i.e., this is
the same update factor used for the
inpatient prospective payment system).
For Fiscal Year 2016, the market basket
rate is 2.4 percent. This year, Medicare
applied two reductions to its market
basket amount: (1) A 0.5 percent
reduction for economy-wide
productivity required by section 3401(a)
of the Patient Protection and Affordable
Care Act (PPACA) which amended
section 1886(b)(3)(B) of the Social
SUMMARY:
PO 00000
Frm 00030
Fmt 4703
Sfmt 4703
Security Act, and (2) a 0.2 percent point
adjustment as required by section
1886(b)(3)(B)(xii) of the Act as added
and amended by sections 3401 and
10319(a) of the PPACA. These two
reductions do not apply to TRICARE.
Hospitals and units with hospitalspecific rates (hospitals and units with
high TRICARE volume) and regionalspecific rates for psychiatric hospitals
and units with low TRICARE volume
will have their TRICARE rates for Fiscal
Year 2016 updated by 2.4 percent.
Partial hospitalization rates for fullday programs also will be updated by
2.4 percent for Fiscal Year 2016. Partial
hospitalization rates for programs of less
than 6 hours (with a minimum of three
hours) will be paid a per diem rate of
75 percent of the rate for a full-day
program.
The cap amount for high-volume
hospitals and units also will be updated
by the 2.4 percent for Fiscal Year 2016.
The beneficiary cost share for lowvolume hospitals and units also will be
updated by the 2.4 percent for Fiscal
Year 2016.
Per Title 32 Code of Federal
Regulations (CFR), Part 199.14, the same
area wage indexes used for the
CHAMPUS Diagnosis-Related Group
(DRG)-based payment system shall be
applied to the wage portion of the
applicable regional per-diem for each
day of the admission. The wage portion
shall be the same as that used for the
CHAMPUS DRG-based payment system.
For wage index values greater than 1.0,
the wage portion of the regional rate
subject to the area wage adjustment is
69.6 percent for Fiscal Year 2016. For
wage index values less than or equal to
1.0, the wage portion of the regional rate
subject to the area wage adjustment is
62.0 percent.
Additionally, 32 CFR part 199.14
requires that hospital specific and
regional per-diems shall be updated by
the Medicare update factor for hospitals
and units exempt from the Medicare
prospective payment system.
The following reflect an update of 2.4
percent for Fiscal Year 2016.
REGIONAL-SPECIFIC RATES FOR PSYCHIATRIC HOSPITALS AND UNITS
WITH LOW TRICARE VOLUME FOR
FISCAL YEAR 2016
United States census region
Northeast:
New England .........................
Mid-Atlantic ...........................
Midwest:
East North Central ................
West North Central ...............
E:\FR\FM\27OCN1.SGM
27OCN1
Regional
rate
$871
840
726
685
65717
Federal Register / Vol. 80, No. 207 / Tuesday, October 27, 2015 / Notices
REGIONAL-SPECIFIC RATES FOR PSYCHIATRIC HOSPITALS AND UNITS
WITH LOW TRICARE VOLUME FOR
FISCAL YEAR 2016—Continued
Regional
rate
United States census region
South:
South Atlantic ........................
East South Central ................
West South Central ...............
West:
Mountain ...............................
Pacific ....................................
864
924
787
786
930
of the hospital billed charges effective
for services rendered on or after October
1, 2015. Cap Amount: Updated cap
amount for hospitals and units with
high TRICARE volume is $1,096 per day
for services on or after October 1, 2015.
Regional
United States census region
rate
The following reflects an update of
2.4 percent for Fiscal Year 2016 for the
Puerto Rico ...........................
593
full day partial hospitalization rates.
Partial hospitalization rates for
Beneficiary cost-share: Beneficiary
programs of less than 6 hours (with a
cost-share (other than dependents of
minimum of three hours) will be paid a
Active Duty members) for care paid on
per diem rate of 75 percent of the rate
the basis of a regional per-diem rate is
the lower of $229 per day or 25 percent
for a full-day program.
REGIONAL-SPECIFIC RATES FOR PSYCHIATRIC HOSPITALS AND UNITS
WITH LOW TRICARE VOLUME FOR
FISCAL YEAR 2016—Continued
PARTIAL HOSPITALIZATION RATES FOR FULL-DAY AND HALF-DAY PROGRAMS
[Fiscal year 2016]
Full-day rate
(6 hours or more)
United States census region
Northeast:
New England (Maine, N.H., Vt., Mass., R.I., Conn.) .............................................................................
Mid-Atlantic:
(N.Y., N.J., Penn.) ..................................................................................................................................
Midwest:
East North Central (Ohio, Ind., Ill., Mich., Wis.) .....................................................................................
West North Central:
(Minn., Iowa, Mo., N.D., S.D., Neb., Kan.) .............................................................................................
South:
South Atlantic (Del., Md., DC, Va., W.Va., N.C., S.C., Ga., Fla.) .........................................................
East South Central:
(Ky., Tenn., Ala., Miss.) ..........................................................................................................................
West South Central:
(Ark., La., Texas, Okla.) .........................................................................................................................
West:
Mountain (Mon., Idaho, Wyo., Col., N.M., Ariz., Utah, Nev.) .................................................................
Pacific (Wash., Ore., Calif., Alaska, Hawaii) ..........................................................................................
Puerto Rico ....................................................................................................................................................
The above rates are effective for
services rendered on or after October 1,
2015.
Dated: October 21, 2015.
Aaron Siegel,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
[FR Doc. 2015–27234 Filed 10–26–15; 8:45 am]
BILLING CODE 5001–06–P
DEPARTMENT OF DEFENSE
[Docket ID: DoD–2015–OS–0104]
Privacy Act of 1974; System of
Records
Defense Finance and
Accounting Service, DoD.
ACTION: Notice to add a new System of
Records.
tkelley on DSK3SPTVN1PROD with NOTICES
AGENCY:
The Defense Finance and
Accounting Service proposes to add a
new system of records, T4500c, entitled
‘‘DFAS Transportation Incentive
Program System (TIPS)’’ to manage the
VerDate Sep<11>2014
19:58 Oct 26, 2015
Jkt 238001
You may submit comments,
identified by docket number and title,
by any of the following methods:
* Federal Rulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments.
* Mail: Department of Defense, Office
of the Deputy Chief Management
Officer, Directorate of Oversight and
Compliance, Regulatory and Audit
Matters Office, 9010 Defense Pentagon,
Washington, DC 20301–9010.
Instructions: All submissions received
must include the agency name and
docket number for this Federal Register
document. The general policy for
comments and other submissions from
ADDRESSES:
Office of the Secretary
SUMMARY:
mass transportation program for DFAS
civilian and DFAS NAF employees
applying for and in receipt of mass
transit subsidies.
DATES: Comments will be accepted on or
before November 27, 2015. This
proposed action will be effective the day
following the end of the comment
period unless comments are received
which result in a contrary
determination.
PO 00000
Frm 00031
Fmt 4703
Sfmt 4703
Half-day rate
(3–5 hours)
$349
$262
380
285
335
251
335
251
357
268
388
291
388
291
391
385
250
293
289
188
members of the public is to make these
submissions available for public
viewing on the Internet at https://
www.regulations.gov as they are
received without change, including any
personal identifiers or contact
information.
Mr.
Gregory Outlaw, Defense Finance and
Accounting Service, Freedom of
Information/Privacy Act Program
Manager, Corporate Communications,
DFAS–ZCF/IN, 8899 E. 56th Street,
Indianapolis, IN 46249–0150 or at (317)
212–4591.
SUPPLEMENTARY INFORMATION: The
Defense Finance and Accounting
Service notices for systems of records
subject to the Privacy Act of 1974 (5
U.S.C. 552a), as amended, have been
published in the Federal Register and
are available from the address in the FOR
FURTHER INFORMATION CONTACT or from
the Defense Privacy and Civil Liberties
Division at https://dpcld.defense.gov/.
The proposed system report, as
required by 5 U.S.C. 552a(r) of the
Privacy Act of 1974, as amended, was
FOR FURTHER INFORMATION CONTACT:
E:\FR\FM\27OCN1.SGM
27OCN1
]]>Agencies
[Federal Register Volume 80, Number 207 (Tuesday, October 27, 2015)]
[Notices]
[Pages 65716-65717]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-27234]
-----------------------------------------------------------------------
DEPARTMENT OF DEFENSE
Office of the Secretary
TRICARE, Formerly Known as the Civilian Health and Medical
Program of the Uniformed Services (CHAMPUS); Fiscal Year 2016 Mental
Health Rate Updates
AGENCY: Department of Defense.
ACTION: Notice of Updated Mental Health Rates for Fiscal Year 2016.
-----------------------------------------------------------------------
SUMMARY: This notice provides the updated regional per-diem rates for
low-volume mental health providers; the update factor for hospital-
specific per-diems; the updated cap per-diem for high-volume providers;
the beneficiary per-diem cost-share amount for low-volume providers;
and, the updated per-diem rates for both full-day and half-day TRICARE
Partial Hospitalization Programs for Fiscal Year 2016.
DATES: Effective Date: The Fiscal Year 2016 rates contained in this
notice are effective for services on or after October 1, 2015.
ADDRESSES: Defense Health Agency (DHA), Medical Benefits and
Reimbursement Section, 16401 East Centretech Parkway, Aurora, CO 80011-
9066.
FOR FURTHER INFORMATION CONTACT: Elan Green, Medical Benefits and
Reimbursement Section, DHA, telephone (303) 676-3907.
SUPPLEMENTARY INFORMATION: The final rule published in the Federal
Register (FR) on September 6, 1988 (53 FR 34285) set forth
reimbursement changes that were effective for all inpatient hospital
admissions in psychiatric hospitals and exempt psychiatric units
occurring on or after January 1, 1989. The final rule published in the
Federal Register on July 1, 1993 (58 FR 35-400) 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 (i.e., this is the same update factor used for the
inpatient prospective payment system). For Fiscal Year 2016, the market
basket rate is 2.4 percent. This year, Medicare applied two reductions
to its market basket amount: (1) A 0.5 percent reduction for economy-
wide productivity required by section 3401(a) of the Patient Protection
and Affordable Care Act (PPACA) which amended section 1886(b)(3)(B) of
the Social Security Act, and (2) a 0.2 percent point adjustment as
required by section 1886(b)(3)(B)(xii) of the Act as added and amended
by sections 3401 and 10319(a) of the PPACA. These two reductions do not
apply to TRICARE. Hospitals and units with hospital-specific rates
(hospitals and units with high TRICARE volume) and regional-specific
rates for psychiatric hospitals and units with low TRICARE volume will
have their TRICARE rates for Fiscal Year 2016 updated by 2.4 percent.
Partial hospitalization rates for full-day programs also will be
updated by 2.4 percent for Fiscal Year 2016. Partial hospitalization
rates for programs of less than 6 hours (with a minimum of three hours)
will be paid a per diem rate of 75 percent of the rate for a full-day
program.
The cap amount for high-volume hospitals and units also will be
updated by the 2.4 percent for Fiscal Year 2016.
The beneficiary cost share for low-volume hospitals and units also
will be updated by the 2.4 percent for Fiscal Year 2016.
Per Title 32 Code of Federal Regulations (CFR), Part 199.14, the
same area wage indexes used for the CHAMPUS Diagnosis-Related Group
(DRG)-based payment system shall be applied to the wage portion of the
applicable regional per-diem for each day of the admission. The wage
portion shall be the same as that used for the CHAMPUS DRG-based
payment system. For wage index values greater than 1.0, the wage
portion of the regional rate subject to the area wage adjustment is
69.6 percent for Fiscal Year 2016. For wage index values less than or
equal to 1.0, the wage portion of the regional rate subject to the area
wage adjustment is 62.0 percent.
Additionally, 32 CFR part 199.14 requires that hospital specific
and regional per-diems shall be updated by the Medicare update factor
for hospitals and units exempt from the Medicare prospective payment
system.
The following reflect an update of 2.4 percent for Fiscal Year
2016.
Regional-Specific Rates for Psychiatric Hospitals and Units With Low
Tricare Volume for Fiscal Year 2016
------------------------------------------------------------------------
Regional
United States census region rate
------------------------------------------------------------------------
Northeast:
New England.............................................. $871
Mid-Atlantic............................................. 840
Midwest:
East North Central....................................... 726
West North Central....................................... 685
[[Page 65717]]
South:
South Atlantic........................................... 864
East South Central....................................... 924
West South Central....................................... 787
West:
Mountain................................................. 786
Pacific.................................................. 930
Puerto Rico.............................................. 593
------------------------------------------------------------------------
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 $229 per day or 25 percent of
the hospital billed charges effective for services rendered on or after
October 1, 2015. Cap Amount: Updated cap amount for hospitals and units
with high TRICARE volume is $1,096 per day for services on or after
October 1, 2015.
The following reflects an update of 2.4 percent for Fiscal Year
2016 for the full day partial hospitalization rates. Partial
hospitalization rates for programs of less than 6 hours (with a minimum
of three hours) will be paid a per diem rate of 75 percent of the rate
for a full-day program.
Partial Hospitalization Rates for Full-Day and Half-Day Programs
[Fiscal year 2016]
------------------------------------------------------------------------
Full-day rate (6 Half-day rate
United States census region hours or more) (3-5 hours)
------------------------------------------------------------------------
Northeast:
New England (Maine, N.H., Vt., $349 $262
Mass., R.I., Conn.)...........
Mid-Atlantic:
(N.Y., N.J., Penn.)............ 380 285
Midwest:
East North Central (Ohio, Ind., 335 251
Ill., Mich., Wis.)............
West North Central:
(Minn., Iowa, Mo., N.D., S.D., 335 251
Neb., Kan.)...................
South:
South Atlantic (Del., Md., DC, 357 268
Va., W.Va., N.C., S.C., Ga.,
Fla.).........................
East South Central:
(Ky., Tenn., Ala., Miss.)...... 388 291
West South Central:
(Ark., La., Texas, Okla.)...... 388 291
West:
Mountain (Mon., Idaho, Wyo., 391 293
Col., N.M., Ariz., Utah, Nev.)
Pacific (Wash., Ore., Calif., 385 289
Alaska, Hawaii)...............
Puerto Rico........................ 250 188
------------------------------------------------------------------------
The above rates are effective for services rendered on or after
October 1, 2015.
Dated: October 21, 2015.
Aaron Siegel,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2015-27234 Filed 10-26-15; 8:45 am]
BILLING CODE 5001-06-P
