Cost-Based and Inter-Agency Billing Rates for Medical Care or Services Provided by the Department of Veterans Affairs, 43958-43959 [2018-18555]
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43958
Federal Register / Vol. 83, No. 167 / Tuesday, August 28, 2018 / Notices
Abraham Lincoln National Cemetery
(20953 West Hoff Road, Elwood, IL
60421).
On Thursday, September 13, the
Committee will convene an open
session at the Jesse Brown VA Medical
Center; 820 South Damen Avenue,
Chicago, IL 60612, from 8:30 a.m. to
3:00 p.m. in the Prescription Conference
Room JB 2446B (2nd Floor, Damen
Building). The agenda will include
overview briefings from the Jesse Brown
VA Medical Center leadership on the
facilities, programs, demographics,
women Veterans programs, and other
services available for Veterans in
Chicago. In the afternoon, the
Committee will reconvene a closed
session, as it tours the Jesse Brown VA
Medical Center.
In the morning of Friday, September
14, the Committee will convene an open
session at the Jesse Brown VA Medical
Center; 820 South Damen Avenue,
Chicago, IL 60612, from 8:00 a.m. to
9:00 a.m. in the Prescription Conference
Room JB 2446B (2nd Floor, Damen
Building), as it conducts an out-briefing
with leadership from the Jesse Brown
VA Medical Center / Edward Hines
Junior Hospital / Captain James A.
Lovell Federal Health Care Center /
Chicago Regional Benefits Office /
Abraham Lincoln National Cemetery.
The Committee will reconvene an open
session in the Prescription Conference
Room JB 2446B (2nd Floor, Damen
Building), as it participates in a town
hall meeting with the women Veterans
and other stakeholders. The town hall
meeting will begin at 9:30 a.m. and end
promptly at 11:00 a.m.
With the exception of the town hall
meeting, there will be no time for public
comment during the meeting. Members
of the public may submit written
statements for the Committee’s review
to 00W@mail.va.gov, or by fax at (202)
273–7092. Any member of the public
and media wishing to attend or seeking
additional information should contact
Shannon L. Middleton at (202) 461–
6193, or 00W@mail.va.gov.
Dated: August 23, 2018.
Jelessa M. Burney,
Federal Advisory Committee Management
Officer.
[FR Doc. 2018–18626 Filed 8–27–18; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
Cost-Based and Inter-Agency Billing
Rates for Medical Care or Services
Provided by the Department of
Veterans Affairs
Department of Veterans Affairs.
Notice.
AGENCY:
ACTION:
This document updates the
Cost-Based and Inter-Agency billing
rates for medical care or services
provided by the Department of Veterans
Affairs (VA) furnished in certain
circumstances.
DATES: The rates set forth herein are
effective August 28, 2018 and until
further notice.
FOR FURTHER INFORMATION CONTACT:
Romona Greene, Office of Community
Care, Revenue Operations, Payer
Relations and Services, Rates and
Charges (10D1C1), 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’s
methodology for computing Cost-Based
and Inter-Agency rates for medical care
or services provided by VA is set forth
in 38 CFR 17.102(h). Two sets of rates
are obtained by applying this
methodology, Cost-Based and InterAgency.
In accordance with 38 CFR 17.102(a),
(b), (d), and (g) respectively, Cost-Based
SUMMARY:
rates apply to medical care and services
that are provided by VA:
• In error or based on tentative
eligibility,
• In a medical emergency,
• To pensioners of allied nations; and
• For research purposes in
circumstances under which the medical
care appropriation shall be reimbursed
from the research appropriation.
In accordance with 38 CFR 17.102(c)
and (f), Inter-Agency rates apply to
medical care and services that are
provided by VA to beneficiaries of the
Department of Defense or other Federal
agencies, when the care or services
provided is not covered by an
applicable sharing agreement, unless
otherwise stated.
The calculations for the Cost-Based
and Inter-Agency rates are the same
with two exceptions. Inter-Agency rates
are all-inclusive, are not broken down
into three components (Physician;
Ancillary; and Nursing, Room, and
Board), and do not include standard
fringe benefit costs that cover
Government employee retirement,
disability costs, and return on fixed
assets. When VA pays for medical care
or services from a non-VA source under
circumstances in which the Cost-Based
or Inter-Agency rates would apply if the
care or services had been provided by
VA, the charge for such care or services
will be the actual amount paid by VA
for the care or services. Inpatient
charges will be at the per diem rates
shown for the type of bed section or
discrete treatment unit providing the
care.
The following table depicts the CostBased and Inter-Agency rates that are
effective upon publication of this notice
and will remain in effect until the next
Federal Register notice is published.
These rates supersede those established
by the Federal Register notice
published on August, 29 2017, at 82 FR
41093.
daltland on DSKBBV9HB2PROD with NOTICES
Cost-Based
rates
A. Hospital Care per inpatient day:
General Medicine:
All Inclusive Rate ...............................................................................................................................
Physician ...........................................................................................................................................
Ancillary .............................................................................................................................................
Nursing Room and Board .................................................................................................................
Neurology:
All Inclusive Rate ...............................................................................................................................
Physician ...........................................................................................................................................
Ancillary .............................................................................................................................................
Nursing Room and Board .................................................................................................................
Rehabilitation Medicine:
All Inclusive Rate ...............................................................................................................................
Physician ...........................................................................................................................................
Ancillary .............................................................................................................................................
Nursing Room and Board .................................................................................................................
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Inter-Agency
rates
$4,025
482
1,049
2,494
$3,882
3,805
557
1,005
2,243
3,664
2,749
312
840
1,597
2,641
43959
Federal Register / Vol. 83, No. 167 / Tuesday, August 28, 2018 / Notices
Cost-Based
rates
Blind Rehabilitation:
All Inclusive Rate ...............................................................................................................................
Physician ...........................................................................................................................................
Ancillary .............................................................................................................................................
Nursing Room and Board .................................................................................................................
Spinal Cord Injury:
All Inclusive Rate ...............................................................................................................................
Physician ...........................................................................................................................................
Ancillary .............................................................................................................................................
Nursing Room and Board .................................................................................................................
Surgery:
All Inclusive Rate ...............................................................................................................................
Physician ...........................................................................................................................................
Ancillary .............................................................................................................................................
Nursing Room and Board .................................................................................................................
General Psychiatry:
All Inclusive Rate ...............................................................................................................................
Physician ...........................................................................................................................................
Ancillary .............................................................................................................................................
Nursing Room and Board .................................................................................................................
Substance Abuse (Alcohol and Drug Treatment):
All Inclusive Rate ...............................................................................................................................
Physician ...........................................................................................................................................
Ancillary .............................................................................................................................................
Nursing Room and Board .................................................................................................................
Psychosocial Residential Rehabilitation Program:
All Inclusive Rate ...............................................................................................................................
Physician ...........................................................................................................................................
Ancillary .............................................................................................................................................
Nursing Room and Board .................................................................................................................
Intermediate Medicine:
All Inclusive Rate ...............................................................................................................................
Physician ...........................................................................................................................................
Ancillary .............................................................................................................................................
Nursing Room and Board .................................................................................................................
Poly-trauma Inpatient:
All Inclusive Rate ...............................................................................................................................
Physician ...........................................................................................................................................
Ancillary .............................................................................................................................................
Nursing Room and Board .................................................................................................................
B. Nursing Home Care, Per Day:
All Inclusive Rate ......................................................................................................................................
Physician ..................................................................................................................................................
Ancillary ....................................................................................................................................................
Nursing Room and Board .........................................................................................................................
C. Outpatient Medical Treatments:
Outpatient Visit (to include Ineligible Emergency Dental Care) ...............................................................
Outpatient Physical Medicine & Rehabilitation Service Visit ...................................................................
Outpatient Poly-trauma/Traumatic Brain Injury ........................................................................................
Inter-Agency
rates
1,843
148
916
779
1,770
2,431
301
612
1,518
2,338
6,832
753
2,072
4,007
6,590
1,993
188
314
1,491
1,913
1,963
187
454
1,322
1,884
768
48
81
639
740
2,483
122
364
1,997
2,388
3,113
354
951
1,808
2,981
1,268
39
172
1057
1,218
362
223
602
350
213
580
Note: Outpatient Prescriptions will be billed at Drug Cost plus Administrative Fee.
Signing Authority
The Secretary of Veterans Affairs
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. Robert L. Wilkie,
Secretary, Department of Veterans
Affairs, approved this document on
August 22, 2018, for publication.
Dated: August 22, 2018.
Jeffrey M. Martin,
Impact Analyst, Office of Regulation Policy
& Management, Office of the Secretary,
Department of Veterans Affairs.
[FR Doc. 2018–18555 Filed 8–27–18; 8:45 am]
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BILLING CODE 8320–01–P
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]]>Agencies
[Federal Register Volume 83, Number 167 (Tuesday, August 28, 2018)]
[Notices]
[Pages 43958-43959]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-18555]
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
Cost-Based and Inter-Agency Billing Rates for Medical Care or
Services Provided by the Department of Veterans Affairs
AGENCY: Department of Veterans Affairs.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This document updates the Cost-Based and Inter-Agency billing
rates for medical care or services provided by the Department of
Veterans Affairs (VA) furnished in certain circumstances.
DATES: The rates set forth herein are effective August 28, 2018 and
until further notice.
FOR FURTHER INFORMATION CONTACT: Romona Greene, Office of Community
Care, Revenue Operations, Payer Relations and Services, Rates and
Charges (10D1C1), 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's methodology for computing Cost-Based
and Inter-Agency rates for medical care or services provided by VA is
set forth in 38 CFR 17.102(h). Two sets of rates are obtained by
applying this methodology, Cost-Based and Inter-Agency.
In accordance with 38 CFR 17.102(a), (b), (d), and (g)
respectively, Cost-Based rates apply to medical care and services that
are provided by VA:
In error or based on tentative eligibility,
In a medical emergency,
To pensioners of allied nations; and
For research purposes in circumstances under which the
medical care appropriation shall be reimbursed from the research
appropriation.
In accordance with 38 CFR 17.102(c) and (f), Inter-Agency rates
apply to medical care and services that are provided by VA to
beneficiaries of the Department of Defense or other Federal agencies,
when the care or services provided is not covered by an applicable
sharing agreement, unless otherwise stated.
The calculations for the Cost-Based and Inter-Agency rates are the
same with two exceptions. Inter-Agency rates are all-inclusive, are not
broken down into three components (Physician; Ancillary; and Nursing,
Room, and Board), and do not include standard fringe benefit costs that
cover Government employee retirement, disability costs, and return on
fixed assets. When VA pays for medical care or services from a non-VA
source under circumstances in which the Cost-Based or Inter-Agency
rates would apply if the care or services had been provided by VA, the
charge for such care or services will be the actual amount paid by VA
for the care or services. Inpatient charges will be at the per diem
rates shown for the type of bed section or discrete treatment unit
providing the care.
The following table depicts the Cost-Based and Inter-Agency rates
that are effective upon publication of this notice and will remain in
effect until the next Federal Register notice is published. These rates
supersede those established by the Federal Register notice published on
August, 29 2017, at 82 FR 41093.
------------------------------------------------------------------------
Inter-Agency
Cost-Based rates rates
------------------------------------------------------------------------
A. Hospital Care per inpatient day:
General Medicine:
All Inclusive Rate.......... $4,025 $3,882
Physician................... 482
Ancillary................... 1,049
Nursing Room and Board...... 2,494
Neurology:
All Inclusive Rate.......... 3,805 3,664
Physician................... 557
Ancillary................... 1,005
Nursing Room and Board...... 2,243
Rehabilitation Medicine:
All Inclusive Rate.......... 2,749 2,641
Physician................... 312
Ancillary................... 840
Nursing Room and Board...... 1,597
[[Page 43959]]
Blind Rehabilitation:
All Inclusive Rate.......... 1,843 1,770
Physician................... 148
Ancillary................... 916
Nursing Room and Board...... 779
Spinal Cord Injury:
All Inclusive Rate.......... 2,431 2,338
Physician................... 301
Ancillary................... 612
Nursing Room and Board...... 1,518
Surgery:
All Inclusive Rate.......... 6,832 6,590
Physician................... 753
Ancillary................... 2,072
Nursing Room and Board...... 4,007
General Psychiatry:
All Inclusive Rate.......... 1,993 1,913
Physician................... 188
Ancillary................... 314
Nursing Room and Board...... 1,491
Substance Abuse (Alcohol and
Drug Treatment):
All Inclusive Rate.......... 1,963 1,884
Physician................... 187
Ancillary................... 454
Nursing Room and Board...... 1,322
Psychosocial Residential
Rehabilitation Program:
All Inclusive Rate.......... 768 740
Physician................... 48
Ancillary................... 81
Nursing Room and Board...... 639
Intermediate Medicine:
All Inclusive Rate.......... 2,483 2,388
Physician................... 122
Ancillary................... 364
Nursing Room and Board...... 1,997
Poly-trauma Inpatient:
All Inclusive Rate.......... 3,113 2,981
Physician................... 354
Ancillary................... 951
Nursing Room and Board...... 1,808
B. Nursing Home Care, Per Day:
All Inclusive Rate.............. 1,268 1,218
Physician....................... 39
Ancillary....................... 172
Nursing Room and Board.......... 1057
C. Outpatient Medical Treatments:
Outpatient Visit (to include 362 350
Ineligible Emergency Dental
Care)..........................
Outpatient Physical Medicine & 223 213
Rehabilitation Service Visit...
Outpatient Poly-trauma/Traumatic 602 580
Brain Injury...................
------------------------------------------------------------------------
Note: Outpatient Prescriptions will be billed at Drug Cost plus
Administrative Fee.
Signing Authority
The Secretary of Veterans Affairs 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. Robert L.
Wilkie, Secretary, Department of Veterans Affairs, approved this
document on August 22, 2018, for publication.
Dated: August 22, 2018.
Jeffrey M. Martin,
Impact Analyst, Office of Regulation Policy & Management, Office of the
Secretary, Department of Veterans Affairs.
[FR Doc. 2018-18555 Filed 8-27-18; 8:45 am]
BILLING CODE 8320-01-P
