Notice of Meeting, 81295 [2015-32419]
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Federal Register / Vol. 80, No. 249 / Tuesday, December 29, 2015 / Notices
Authority: 16 U.S.C. 1801 et seq.
[FR Doc. 2015–32715 Filed 12–28–15; 8:45 am]
BILLING CODE 3510–22–P
COMMISSION OF FINE ARTS
Notice of Meeting
The next meeting of the U.S.
Commission of Fine Arts is scheduled
for 21 January 2016, at 9:00 a.m. in the
Commission offices at the National
Building Museum, Suite 312, Judiciary
Square, 401 F Street NW., Washington,
DC 20001–2728. Items of discussion
may include buildings, parks and
memorials.
Draft agendas and additional
information regarding the Commission
are available on our Web site:
www.cfa.gov. Inquiries regarding the
agenda and requests to submit written
or oral statements should be addressed
to Thomas Luebke, Secretary, U.S.
Commission of Fine Arts, at the above
address; by emailing cfastaff@cfa.gov; or
by calling 202–504–2200. Individuals
requiring sign language interpretation
for the hearing impaired should contact
the Secretary at least 10 days before the
meeting date.
Dated: December 18, 2015 in Washington,
DC.
Thomas Luebke,
Secretary.
[FR Doc. 2015–32419 Filed 12–28–15; 8:45 am]
BILLING CODE 6330–01–M
DEPARTMENT OF DEFENSE
Office of the Secretary
TRICARE; Civilian Health and Medical
Program of the Uniformed Services
(CHAMPUS); Fiscal Year 2016
Diagnosis Related Group (DRG)
Updates
Office of the Secretary,
Department of Defense, DoD.
ACTION: Notice of DRG revised rates.
AGENCY:
This notice describes the
changes made to the TRICARE DRGbased payment system in order to
conform to changes made to the
Medicare Prospective Payment System
(PPS).
It also provides the updated fixed loss
cost outlier threshold, cost-to-charge
ratios, and the data necessary to update
the FY 2016 rates.
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SUMMARY:
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Effective Date: The rates,
weights, and Medicare PPS changes
which affect the TRICARE DRG-based
payment system contained in this notice
are effective for discharges occurring on
or after October 1, 2015.
ADDRESSES: Defense Health Agency,
TRICARE, Medical Benefits and
Reimbursement Section, 16401 East
Centretech Parkway, Aurora, CO 80011–
9066.
FOR FURTHER INFORMATION CONTACT:
Sharon L. Seelmeyer, Medical Benefits
and Reimbursement Section, TRICARE,
telephone (303) 676–3690. Questions
regarding payment of specific claims
under the TRICARE DRG-based
payment system should be addressed to
the appropriate contractor.
SUPPLEMENTARY INFORMATION: The final
rule published on September 1, 1987 (52
FR 32992) set forth the basic procedures
used under the CHAMPUS DRG-based
payment system. This was subsequently
amended by final rules published
August 31, 1988 (53 FR 33461); October
21, 1988 (53 FR 41331); December 16,
1988 (53 FR 50515); May 30, 1990 (55
FR 21863); October 22, 1990 (55 FR
42560); and September 10, 1998 (63 FR
48439).
An explicit tenet of these final rules,
and one based on the statute authorizing
the use of DRGs by TRICARE, is that the
TRICARE DRG-based payment system is
modeled on the Medicare PPS, and that,
whenever practicable, the TRICARE
system will follow the same rules that
apply to the Medicare PPS. The Centers
for Medicare and Medicaid Services
(CMS) publishes these changes annually
in the Federal Register and discusses in
detail the impact of the changes.
In addition, this notice updates the
rates and weights in accordance with
our previous final rules. The actual
changes we are making, along with a
description of their relationship to the
Medicare PPS, are detailed in this
notice.
DATES:
Dated: December 23, 2015.
Tracey L. Thompson,
Acting Deputy Director, Office of Sustainable
Fisheries, National Marine Fisheries Service.
I. Medicare PPS Changes Which Affect
the TRICARE DRG-Based Payment
System
Following is a discussion of the
changes CMS has made to the Medicare
PPS that affect the TRICARE DRG-based
payment system.
A. DRG Classifications
Under both the Medicare PPS and the
TRICARE DRG-based payment system,
cases are classified into the appropriate
DRG by a Grouper program. The
Grouper classifies each case into a DRG
on the basis of the diagnosis and
procedure codes and demographic
information (that is, sex, age, and
PO 00000
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Sfmt 4703
81295
discharge status). The Grouper used for
the TRICARE DRG-based payment
system is the same as the current
Medicare Grouper with certain
modifications. For FY 2008, Medicare
implemented their Medicare-Severity
DRG (MS–DRG) based payment system.
TRICARE, however, continued with the
Centers for Medicare and Medicaid
Services DRG-based (CMS–DRG)
payment system for FY 2008. For FY
2009, the TRICARE/CHAMPUS DRGbased payment system shall be modeled
on the MS–DRG system, with the
following modifications.
The MS–DRG system consolidated the
43 pediatric CMS DRGs that were
defined based on age less than or equal
to 17 into the most clinically similar
MS–DRGs. In their Inpatient Prospective
Payment System final rule for MS–
DRGs, Medicare stated for their
population these pediatric CMS DRGs
contained a very low volume of
Medicare patients. At the same time,
Medicare encouraged private insurers
and other non-Medicare payers to make
refinements to MS–DRGs to better suit
the needs of the patients they serve.
Consequently, TRICARE finds it
appropriate to retain the pediatric CMS–
DRGs for our population. TRICARE is
also retaining the TRICARE-specific
DRGs for neonates and substance use.
For FY09, TRICARE will use the MS–
DRG v26.0 pre-MDC hierarchy, with the
exception that MDC 15 is applied after
DRG 011–012 and before MDC 24.
For FY10, there are no additional or
deleted DRGs.
For FY 11, the added DRGs and
deleted DRGs are the same as those
included in CMS’ final rule published
on August 16, 2010. That is, DRG 009
is deleted; DRGs 014 and 015 are being
added.
For FY 12, the added DRGs and
deleted DRGs are the same as those
included in CMS’ final rule published
on August 18, 2011 (76 FR 51476–
51846). That is, DRG 015 is deleted;
DRGs 016 and 017 are being added.
For FY 2013 there are no new,
revised, or deleted DRGs.
For FY 2014 there are no new,
revised, or deleted DRGs.
For FY 2015 the added, deleted, and
revised DRGs are the same as those
included in the CMS’ final rule
published on August 22, 2014 (79 FR
49880) with the exception of
endovascular cardiac valve replacement
for which CMS added DRGs 266/267
and TRICARE added DRGs 317/318
because the TRICARE Grouper already
has DRGs 266/267 assigned to pediatric
procedures.
For FY2016 the added, deleted, and
revised DRGs are the same as those
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29DEN1
Agencies
[Federal Register Volume 80, Number 249 (Tuesday, December 29, 2015)]
[Notices]
[Page 81295]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-32419]
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COMMISSION OF FINE ARTS
Notice of Meeting
The next meeting of the U.S. Commission of Fine Arts is scheduled
for 21 January 2016, at 9:00 a.m. in the Commission offices at the
National Building Museum, Suite 312, Judiciary Square, 401 F Street
NW., Washington, DC 20001-2728. Items of discussion may include
buildings, parks and memorials.
Draft agendas and additional information regarding the Commission
are available on our Web site: www.cfa.gov. Inquiries regarding the
agenda and requests to submit written or oral statements should be
addressed to Thomas Luebke, Secretary, U.S. Commission of Fine Arts, at
the above address; by emailing cfastaff@cfa.gov; or by calling 202-504-
2200. Individuals requiring sign language interpretation for the
hearing impaired should contact the Secretary at least 10 days before
the meeting date.
Dated: December 18, 2015 in Washington, DC.
Thomas Luebke,
Secretary.
[FR Doc. 2015-32419 Filed 12-28-15; 8:45 am]
BILLING CODE 6330-01-M