Reasonable Charges for Inpatient Medical Severity-Diagnosis Related Groups (MS-DRG) and Skilled Nursing Facility (SNF) Medical Services; v3.26, Fiscal Year (FY) 2020 Update, 51727-51728 [2019-21329]
Download as PDF
<![CDATA[
Federal Register / Vol. 84, No. 189 / Monday, September 30, 2019 / Notices
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.
Authority: Public Law 104–13; 44
U.S.C. 3501–21.
Title: HUDVA Addendum to Uniform
Residential Loan Application, VA form
26–1802a.
OMB Control Number: 2900–0144.
Type of Review: Extension of a
currently approved collection.
Abstract: VA Form 26–1802a,
Department of Housing and Urban
Development (HUD)/Department of
Veterans Affairs (VA) Addendum to
Uniform Residential Loan Application,
serve as the lender’s and veteran’s
application for home loans authorized
by 38 U.S.C.
Affected Public: Individuals or
households.
Estimated Annual Burden: 35,000
hours.
Estimated Average Burden per
Respondent: 6 minutes.
Frequency of Response: One-time.
Estimated Number of Respondents:
350,000.
By direction of the Secretary.
Danny S. Green,
Interim VA Clearance Officer, Office of
Quality, Performance and Risk, Department
of Veterans Affairs.
[FR Doc. 2019–21148 Filed 9–27–19; 8:45 am]
BILLING CODE 8320–01–P
DEPARTMENT OF VETERANS
AFFAIRS
Reasonable Charges for Inpatient
Medical Severity-Diagnosis Related
Groups (MS–DRG) and Skilled Nursing
Facility (SNF) Medical Services; v3.26,
Fiscal Year (FY) 2020 Update
Department of Veterans Affairs.
Notice.
AGENCY:
ACTION:
This document updates the
acute inpatient and the skilled nursing
facility (SNF)/sub-acute inpatient
facility charges. The updated charges
are based on the Medicare severitydiagnosis related groups (MS–DRG) for
Fiscal Year (FY) 2020.
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; email:
Romona.Greene@va.gov; telephone:
khammond on DSKJM1Z7X2PROD with NOTICES
SUMMARY:
VerDate Sep<11>2014
19:16 Sep 27, 2019
Jkt 247001
(202) 382–2521 (This is not a toll-free
number.)
SUPPLEMENTARY INFORMATION: Section
17.101(a)(1) of title 38 of the Code of
Federal Regulations (CFR) sets forth the
Department of Veterans Affairs (VA)
medical regulations concerning
‘‘Reasonable Charges’’ for medical care
or services provided or furnished by VA
to a Veteran: For a nonserviceconnected disability for which the
Veteran is entitled to care (or the
payment of expenses of care) under a
health plan contract; for 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, for a
nonservice-connected disability
incurred as a result of a motor vehicle
accident in a state that requires
automobile accident reparations
insurance. The methodologies for
establishing billed amounts for several
types of charges are found in 38 CFR
17.101; however, this notice will only
address the acute inpatient and the
SNF/sub-acute inpatient facility
charges.
Based on the methodologies set forth
in 38 CFR 17.101(b), this notice updates
the acute inpatient facility charges that
were based on the FY 2019 MS–DRGs.
Acute inpatient facility charges by MS–
DRGs are posted on the Veterans Health
Administration (VHA) Office of
Community Care’s website, at the
following link: www.va.gov/
communitycare/revenue_ops/payer_
rates.asp, under the ‘‘Reasonable
Charges Data Tables’’ section, Inpatient
Data Table, as Table A (v3.24). This
Table A corresponds to the Table A
referenced in 83 Federal Register (FR)
47412, September 19, 2018. Table A
(v3.26) referenced in this notice
provides updated charges based on the
FY 2020 MS–DRGs and will replace
Table A (v3.24) posted on the VHA
Office of Community Care’s website.
Also, this document updates the SNF/
sub-acute inpatient facility all-inclusive
per diem charge using the
methodologies set forth in 38 CFR
17.101(c). This charge is adjusted by a
geographic area factor that is based on
the location where the care is provided.
For the geographic area factors, see
Table N, Acute Inpatient, and Table O,
SNF, on the VHA Office of Community
Care’s website under the v3.25 link in
the ‘‘Reasonable Charges Data Tables’’
section. Tables N and O are not being
updated by this notice. The SNF/subacute inpatient facility per diem charge
is posted on the VHA Office of
PO 00000
Frm 00220
Fmt 4703
Sfmt 4703
51727
Community Care’s website under the
‘‘Reasonable Charges Data Tables’’
section, Table B (v3.24). This Table B
corresponds to the Table B referenced in
83 FR 47412, September 19, 2018. Table
B referenced in this notice is v3.26,
which provides an update to the allinclusive nationwide SNF/sub-acute
inpatient facility per diem charge and
will replace Table B (v3.24) posted on
the VHA Office of Community Care’s
website.
The charges in this notice for acute
inpatient and SNF/sub-acute inpatient
facility services are effective October 1,
2019.
This notice is retaining the table
designations used for acute inpatient
facility charges by MS–DRGs, which are
posted on the VHA Office of
Community Care’s website under
‘‘Reasonable Charges Data Tables.’’ This
notice is also retaining the table
designation used for SNF/sub-acute
inpatient facility charges, which are also
posted on the VHA Office of
Community Care’s website.
Accordingly, the tables identified as
being updated by this notice correspond
to the applicable tables referenced in 83
FR 47412, September 19, 2018.
The list of data sources presented in
Supplementary Table 1 (v3.26) reflects
the updated data sources used to
establish the updated charges described
in this notice and will be posted on the
VHA Office of Community Care’s
website under the ‘‘Reasonable Charges
Data Sources’’ section.
The list of VA medical facility
locations is also updated. In
Supplementary Table 3, posted on the
VHA Office of Community Care’s
website under the VA Medical Facility
Locations section, VA set forth the list
of VA medical facility locations, which
includes the first three digits of their zip
codes and provider-based/non-providerbased designations.
Consistent with VA’s regulations, the
updated data tables and supplementary
tables containing the changes described
in this notice will be posted on the VHA
Office of Community Care’s website,
under the ‘‘Payer Rates and Charges’’
information section.
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.
Robert L. Wilkie, Secretary, Department
of Veterans Affairs, approved this
document on September 26, 2019, for
publication.
E:\FR\FM\30SEN1.SGM
30SEN1
51728
Federal Register / Vol. 84, No. 189 / Monday, September 30, 2019 / Notices
Dated: September 26, 2019.
Jeffrey M. Martin,
Assistant Director, Office of Regulation Policy
& Management, Office of the Secretary,
Department of Veterans Affairs.
[FR Doc. 2019–21329 Filed 9–27–19; 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 for FY 2020
The Department of Veterans
Affairs.
ACTION: Notice.
ADDRESSES:
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 October 1, 2019.
FOR FURTHER INFORMATION CONTACT:
Romona Greene, Office of Community
Care, Revenue Operations, Payer
Relations and Services, Rates and
Charges (10D1C1), Veterans Health
Administration (VHA), Department of
SUMMARY:
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 Code of Federal Regulations
17.102(h). Two sets of rates are obtained
by applying this methodology, CostBased and Inter-Agency.
Cost-Based rates apply to medical care
and services that are provided by VA
under § 17.102(a), (b), (d) and (g),
respectively, in the following
circumstances:
• 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.
Inter-Agency rates apply to medical
care and services that are provided by
VA under § 17.102(c) and (f),
respectively, in the following
circumstances when the care or services
provided are not covered by any
applicable sharing agreement in
accordance with § 17.102(e):
• To beneficiaries of the Department
of Defense or other Federal agencies;
and
• To military retirees with chronic
disability.
The calculations for the Cost-Based
and Inter-Agency rates are the same
with two exceptions. Inter-Agency rates
are all-inclusive and are not broken
down into three components (i.e.,
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 October 1, 2019 and will
remain in effect until the next fiscal year
Federal Register update. These rates
supersede those established by the
Federal Register notice published on
August 28, 2018, at 83 FR 43958.
khammond on DSKJM1Z7X2PROD 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 .........................................................................................................................
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 ...................................................................................................................................................
VerDate Sep<11>2014
19:16 Sep 27, 2019
Jkt 247001
PO 00000
Frm 00221
Fmt 4703
Sfmt 4703
E:\FR\FM\30SEN1.SGM
30SEN1
Inter-agency
rates
$4,301
515
1,121
2,665
$4,156
........................
........................
........................
4,232
620
1,117
2,495
4,086
........................
........................
........................
2,910
331
889
1,690
2,803
........................
........................
........................
1,995
161
991
843
1,920
........................
........................
........................
2,636
327
663
1,646
2,540
........................
........................
........................
7,526
829
2,283
4,414
7,272
........................
........................
........................
2,174
205
2,091
........................
]]>Agencies
[Federal Register Volume 84, Number 189 (Monday, September 30, 2019)]
[Notices]
[Pages 51727-51728]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-21329]
-----------------------------------------------------------------------
DEPARTMENT OF VETERANS AFFAIRS
Reasonable Charges for Inpatient Medical Severity-Diagnosis
Related Groups (MS-DRG) and Skilled Nursing Facility (SNF) Medical
Services; v3.26, Fiscal Year (FY) 2020 Update
AGENCY: Department of Veterans Affairs.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: This document updates the acute inpatient and the skilled
nursing facility (SNF)/sub-acute inpatient facility charges. The
updated charges are based on the Medicare severity-diagnosis related
groups (MS-DRG) for Fiscal Year (FY) 2020.
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; email:
[email protected]; telephone: (202) 382-2521 (This is not a toll-
free number.)
SUPPLEMENTARY INFORMATION: Section 17.101(a)(1) of title 38 of the Code
of Federal Regulations (CFR) sets forth the Department of Veterans
Affairs (VA) medical regulations concerning ``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 of 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. The methodologies for establishing
billed amounts for several types of charges are found in 38 CFR 17.101;
however, this notice will only address the acute inpatient and the SNF/
sub-acute inpatient facility charges.
Based on the methodologies set forth in 38 CFR 17.101(b), this
notice updates the acute inpatient facility charges that were based on
the FY 2019 MS-DRGs. Acute inpatient facility charges by MS-DRGs are
posted on the Veterans Health Administration (VHA) Office of Community
Care's website, at the following link: www.va.gov/communitycare/revenue_ops/payer_rates.asp, under the ``Reasonable Charges Data
Tables'' section, Inpatient Data Table, as Table A (v3.24). This Table
A corresponds to the Table A referenced in 83 Federal Register (FR)
47412, September 19, 2018. Table A (v3.26) referenced in this notice
provides updated charges based on the FY 2020 MS-DRGs and will replace
Table A (v3.24) posted on the VHA Office of Community Care's website.
Also, this document updates the SNF/sub-acute inpatient facility
all-inclusive per diem charge using the methodologies set forth in 38
CFR 17.101(c). This charge is adjusted by a geographic area factor that
is based on the location where the care is provided. For the geographic
area factors, see Table N, Acute Inpatient, and Table O, SNF, on the
VHA Office of Community Care's website under the v3.25 link in the
``Reasonable Charges Data Tables'' section. Tables N and O are not
being updated by this notice. The SNF/sub-acute inpatient facility per
diem charge is posted on the VHA Office of Community Care's website
under the ``Reasonable Charges Data Tables'' section, Table B (v3.24).
This Table B corresponds to the Table B referenced in 83 FR 47412,
September 19, 2018. Table B referenced in this notice is v3.26, which
provides an update to the all-inclusive nationwide SNF/sub-acute
inpatient facility per diem charge and will replace Table B (v3.24)
posted on the VHA Office of Community Care's website.
The charges in this notice for acute inpatient and SNF/sub-acute
inpatient facility services are effective October 1, 2019.
This notice is retaining the table designations used for acute
inpatient facility charges by MS-DRGs, which are posted on the VHA
Office of Community Care's website under ``Reasonable Charges Data
Tables.'' This notice is also retaining the table designation used for
SNF/sub-acute inpatient facility charges, which are also posted on the
VHA Office of Community Care's website. Accordingly, the tables
identified as being updated by this notice correspond to the applicable
tables referenced in 83 FR 47412, September 19, 2018.
The list of data sources presented in Supplementary Table 1 (v3.26)
reflects the updated data sources used to establish the updated charges
described in this notice and will be posted on the VHA Office of
Community Care's website under the ``Reasonable Charges Data Sources''
section.
The list of VA medical facility locations is also updated. In
Supplementary Table 3, posted on the VHA Office of Community Care's
website under the VA Medical Facility Locations section, VA set forth
the list of VA medical facility locations, which includes the first
three digits of their zip codes and provider-based/non-provider-based
designations.
Consistent with VA's regulations, the updated data tables and
supplementary tables containing the changes described in this notice
will be posted on the VHA Office of Community Care's website, under the
``Payer Rates and Charges'' information section.
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. Robert L.
Wilkie, Secretary, Department of Veterans Affairs, approved this
document on September 26, 2019, for publication.
[[Page 51728]]
Dated: September 26, 2019.
Jeffrey M. Martin,
Assistant Director, Office of Regulation Policy & Management, Office of
the Secretary, Department of Veterans Affairs.
[FR Doc. 2019-21329 Filed 9-27-19; 8:45 am]
BILLING CODE 8320-01-P
