Reasonable Charges for Medical Care or Services; v3.21, 2017 Calendar Year Update and National Average Administrative Prescription Drug Charge Update, 90410-90411 [2016-30008]

Download as PDF 90410 Federal Register / Vol. 81, No. 240 / Wednesday, December 14, 2016 / Notices WELFARE ASSOCIATION; a.k.a. RAHMA WELFARE FOUNDATION), Ash Shihr City, Hadramawt Governorate, Yemen [SDGT] (Linked To: SADIQ AL-AHDAL, Abdallah Faysal). Dated: December 7, 2016. Andrea Gacki, Acting Director, Office of Foreign Assets Control. [FR Doc. 2016–29961 Filed 12–13–16; 8:45 am] BILLING CODE 4810–AL–P DEPARTMENT OF VETERANS AFFAIRS Reasonable Charges for Medical Care or Services; v3.21, 2017 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 updates the data for calculating the ‘‘Reasonable Charges’’ collected or recovered by VA for medical care or services. This notice also updates the ‘‘National Average Administrative Prescription 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 FURTHER INFORMATION CONTACT: Romona Greene, Office of Community Care, Revenue Operations, Consolidated Patient Account Center (CPAC) Rates and Charges (10D1C), Veterans Health Administration (VHA), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 382– 2521. This is not a toll free number. SUPPLEMENTARY INFORMATION: Section 17.101 of 38 Code of Federal Regulations sets forth the ‘‘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 for 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.’’ Section 17.101 provides the methodologies for establishing billed amounts for several types of charges; sradovich on DSK3GMQ082PROD with NOTICES SUMMARY: VerDate Sep<11>2014 18:45 Dec 13, 2016 Jkt 241001 however, this notice will only address 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. Section 17.101 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 at http:// www.va.gov/CBO/apps/rates/index.asp. Certain charges are hereby updated as stated in this notice and will be effective on January 1, 2017. 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). Based on the methodologies set forth in § 17.101, this notice provides an update to charges for 2017 HCPCS Level II and Current Procedural Terminology (CPT) codes. Charges are also being updated based on more 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. As of the date of this notice, the actual charge amounts at individual VA facilities based on the methodologies in § 17.101 will be posted on the VHA Internet site at http://www.va.gov/CBO/apps/rates/ index.asp under the heading ‘‘Reasonable Charges Data Tables’’ and identified as ‘‘v3.21 Data Tables (Outpatient and Professional).’’ The list of data sources used for calculating the actual charge amounts listed above also will be posted on the VHA Internet site at http://www.va.gov/ PO 00000 Frm 00093 Fmt 4703 Sfmt 4703 CBO/apps/rates/index.asp under the heading ‘‘Reasonable Charges Data Sources’’ and identified as ‘‘Reasonable Charges v3.21 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 13, 2016 (80 FR 57051). We are also updating 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-providerbased designations, will be posted on the VHA Internet site at http:// www.va.gov/CBO/apps/rates/index.asp under the heading ‘‘VA Medical Facility Locations’’ and identified as ‘‘v3.21 (Jan17).’’ As indicated 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. VA determines the amount of the national average administrative cost annually for the prior fiscal year (October through September) and then applies the charge at the start of the next calendar year. The national average administrative drug cost for calendar year 2017 is $16.36. This change will be posted at http://www.va.gov/CBO/ payerinfo.asp and identified as ‘‘CY 2017 Average Administrative Cost for Prescriptions.’’ Consistent with § 17.101, the national average administrative cost, the updated data, and supplementary tables containing the changes described in this notice will be posted online, as indicated in this notice. This notice will be posted on the VHA Internet site at http://www.va.gov/CBO/apps/rates/ index.asp under the heading ‘‘Federal Registers, Rules, and Notices’’ and identified as ‘‘v3.21 Federal Register Notice 01/01/17 (Outpatient and Professional), and National Administrative Cost (PDF).’’ The national average administrative cost, updated data, and supplementary tables containing the changes described will be effective until changed by a subsequent Federal Register notice. E:\FR\FM\14DEN1.SGM 14DEN1 Federal Register / Vol. 81, No. 240 / Wednesday, December 14, 2016 / Notices Signing Authority The Secretary of Veterans Affairs, or designee, approved this document and authorized the undersigned to sign and submit the document to the Office of the Federal Register for publication electronically as an official document of the Department of Veterans Affairs. Gina S. Farrisee, Deputy Chief of Staff, Department of Veterans Affairs, approved this document on December 9, 2016, for publication. Dated: December 9, 2016. Michael Shores, Acting Director, Regulation Policy & Management Office of the Secretary, Department of Veterans Affairs. [FR Doc. 2016–30008 Filed 12–13–16; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0043] Agency Information Collection Activity (Declaration of Status of Dependents (VA Form 21–686c) Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. AGENCY: The Veterans Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed revision of a currently approved collection, and allow 60 days for public comment in response to the notice. VA Form 21–686c is necessary to obtain current marital and dependency information in order to determine the proper rate of payment for Veterans and surviving spouses who are entitled to an additional allowance for dependents. DATES: Written comments and recommendations on the proposed collection of information should be received on or before February 13, 2017. ADDRESSES: Submit written comments on the collection of information through Federal Docket Management System (FDMS) at www.Regulations.gov or to Nancy J. Kessinger, Veterans Benefits Administration (20M33), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420 or email to nancy.kessinger@va.gov. Please refer to ‘‘OMB Control No. 2900–0043’’ in any sradovich on DSK3GMQ082PROD with NOTICES SUMMARY: VerDate Sep<11>2014 18:45 Dec 13, 2016 Jkt 241001 correspondence. During the comment period, comments may be viewed online through the FDMS. FOR FURTHER INFORMATION CONTACT: Nancy J. Kessinger at (202) 632–8924 or FAX (202) 632–8925. Under the PRA of 1995 (Pub. L. 104–13; 44 U.S.C. 3501–21), Federal agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor. This request for comment is being made pursuant to Section 3506(c)(2)(A) of the PRA. With respect to the following collection of information, VBA invites comments on: (1) Whether the proposed collection of information is necessary for the proper performance of VBA’s functions, including whether the information will have practical utility; (2) the accuracy of VBA’s estimate of the burden of the proposed collection of information; (3) ways to enhance the quality, utility, and clarity of the information to be collected; and (4) ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques or the use of other forms of information technology. Title: Declaration of Status of Dependents (VA Form 21–686c). OMB Control Number: 2900–0043. Type of Review: Extension of an approved collection. Abstract: VA Form 21–686c is necessary to obtain current marital and dependency information in order to determine the proper rate of payment for Veterans and surviving spouses who are entitled to an additional allowance for dependents. Affected Public: Individuals or households. Estimated Annual Burden: 56,500 hours. Estimated Average Burden per Respondent: 15 minutes. Frequency of Response: One time. Estimated Number of Respondents: 226,000. SUPPLEMENTARY INFORMATION: By direction of the Secretary: Cynthia Harvey-Pryor, VA Clearance Officer, Office of Privacy and Records Management, Department of Veterans Affairs. [FR Doc. 2016–29980 Filed 12–13–16; 8:45 am] BILLING CODE 8320–01–P PO 00000 Frm 00094 Fmt 4703 Sfmt 4703 90411 DEPARTMENT OF VETERANS AFFAIRS Joint Biomedical Laboratory Research and Development and Clinical Science Research and Development Services Scientific Merit Review Board Amended; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92– 463; Title 5 U.S.C. App. 2 (Federal Advisory Committee Act) that the Joint Biomedical Laboratory Research and Development and Clinical Science Research and Development Services Scientific Merit Review Board (JBL/CS SMRB) teleconference meeting will convene on January 26, 2017, from 3:00 p.m. to 3:45 p.m. and will be open to the public. This Notice of Meeting is being amended due to clarification of the meeting being open. This meeting is conducted to meet with the JBL/CS Service Directors to discuss the overall policies and process for Merit Review as well as disseminate information among the subcommittee chairs regarding the VA research priorities. Members of the public who wish to attend the open JBL/CS SMRB teleconference may dial 1–800–767– 1750, participant code 95562. Members of the public who wish to make a statement at the JBL/CS SMRB meeting must notify Dr. Alex Chiu, Designated Federal Officer, via email at alex.chiu@ va.gov by January 19, 2017. Dated: December 9, 2016. LaTonya L. Small, Advisory Committee Management Officer. [FR Doc. 2016–30025 Filed 12–13–16; 8:45 am] BILLING CODE P DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900–0655] Agency Information Collection Activity (Residency Verification ReportVeterans and Survivors (FL 21–914)) Veterans Benefits Administration, Department of Veterans Affairs ACTION: Notice. AGENCY: The Veterans Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of SUMMARY: E:\FR\FM\14DEN1.SGM 14DEN1

Agencies

[Federal Register Volume 81, Number 240 (Wednesday, December 14, 2016)]
[Notices]
[Pages 90410-90411]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-30008]


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DEPARTMENT OF VETERANS AFFAIRS


Reasonable Charges for Medical Care or Services; v3.21, 2017 
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 updates the 
data for calculating the ``Reasonable Charges'' collected or recovered 
by VA for medical care or services. This notice also updates the 
``National Average Administrative Prescription 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 FURTHER INFORMATION CONTACT: Romona Greene, Office of Community 
Care, Revenue Operations, Consolidated Patient Account Center (CPAC) 
Rates and Charges (10D1C), Veterans Health Administration (VHA), 
Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 
20420, (202) 382-2521. This is not a toll free number.

SUPPLEMENTARY INFORMATION: Section 17.101 of 38 Code of Federal 
Regulations sets forth the ``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 for 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.'' Section 17.101 provides the methodologies for 
establishing billed amounts for several types of charges; however, this 
notice will only address 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.
    Section 17.101 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 at http://www.va.gov/CBO/apps/rates/index.asp. Certain charges are hereby updated 
as stated in this notice and will be effective on January 1, 2017.
    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).
    Based on the methodologies set forth in Sec.  17.101, this notice 
provides an update to charges for 2017 HCPCS Level II and Current 
Procedural Terminology (CPT) codes. Charges are also being updated 
based on more 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. As of 
the date of this notice, the actual charge amounts at individual VA 
facilities based on the methodologies in Sec.  17.101 will be posted on 
the VHA Internet site at http://www.va.gov/CBO/apps/rates/index.asp 
under the heading ``Reasonable Charges Data Tables'' and identified as 
``v3.21 Data Tables (Outpatient and Professional).''
    The list of data sources used for calculating the actual charge 
amounts listed above also will be posted on the VHA Internet site at 
http://www.va.gov/CBO/apps/rates/index.asp under the heading 
``Reasonable Charges Data Sources'' and identified as ``Reasonable 
Charges v3.21 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 13, 2016 (80 FR 
57051).
    We are also updating 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 VHA Internet site at http://www.va.gov/CBO/apps/rates/index.asp under the heading ``VA Medical 
Facility Locations'' and identified as ``v3.21 (Jan17).''
    As indicated 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.
    VA determines the amount of the national average administrative 
cost annually for the prior fiscal year (October through September) and 
then applies the charge at the start of the next calendar year. The 
national average administrative drug cost for calendar year 2017 is 
$16.36. This change will be posted at http://www.va.gov/CBO/payerinfo.asp and identified as ``CY 2017 Average Administrative Cost 
for Prescriptions.''
    Consistent with Sec.  17.101, the national average administrative 
cost, the updated data, and supplementary tables containing the changes 
described in this notice will be posted online, as indicated in this 
notice. This notice will be posted on the VHA Internet site at http://www.va.gov/CBO/apps/rates/index.asp under the heading ``Federal 
Registers, Rules, and Notices'' and identified as ``v3.21 Federal 
Register Notice 01/01/17 (Outpatient and Professional), and National 
Administrative Cost (PDF).'' The national average administrative cost, 
updated data, and supplementary tables containing the changes described 
will be effective until changed by a subsequent Federal Register 
notice.

[[Page 90411]]

Signing Authority

    The Secretary of Veterans Affairs, or designee, approved this 
document and authorized the undersigned to sign and submit the document 
to the Office of the Federal Register for publication electronically as 
an official document of the Department of Veterans Affairs. Gina S. 
Farrisee, Deputy Chief of Staff, Department of Veterans Affairs, 
approved this document on December 9, 2016, for publication.

    Dated: December 9, 2016.
Michael Shores,
Acting Director, Regulation Policy & Management Office of the 
Secretary, Department of Veterans Affairs.
[FR Doc. 2016-30008 Filed 12-13-16; 8:45 am]
 BILLING CODE 8320-01-P