Cost-Based and Inter-Agency Billing Rates for Medical Care or Services Provided by the Department of Veterans Affairs for FY 2020, 51728-51729 [2019-21330]

Download as PDF 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 ........................ 51729 Federal Register / Vol. 84, No. 189 / Monday, September 30, 2019 / Notices Cost-based rates 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 342 1,627 ........................ ........................ 2,232 213 516 1,503 2,147 ........................ ........................ ........................ 826 52 87 687 797 ........................ ........................ ........................ 3,301 162 484 2,655 3,182 ........................ ........................ ........................ 3,223 366 985 1,872 3,097 ........................ ........................ ........................ 1,361 42 184 1135 1,311 ........................ ........................ ........................ 389 238 671 376 228 649 Note: Outpatient Prescriptions will be billed at Drug Cost plus Administrative Fee. 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. Dated: September 26, 2019. Jeffrey M. Martin, Assistant Director, Office of Regulation Policy & Management, Office of the Secretary, Department of Veterans Affairs. [FR Doc. 2019–21330 Filed 9–27–19; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS khammond on DSKJM1Z7X2PROD with NOTICES [OMB Control No. 2900–0144] Agency Information Collection Activity: HUDVA Addendum to Uniform Residential Loan Application Veterans Benefits Administration; Department of Veterans Affairs. ACTION: Notice. AGENCY: VerDate Sep<11>2014 19:16 Sep 27, 2019 Veterans Benefits Administration, 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 extension of a currently approved collection, and allow 60 days for public comment in response to the notice. DATES: Written comments and recommendations on the proposed collection of information should be received on or before November 29, 2019. 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. 2900–0144’’ in any correspondence. During the comment period, comments may be viewed online through FDMS. FOR FURTHER INFORMATION CONTACT: Danny Green at (202) 421–1354. SUMMARY: Jkt 247001 PO 00000 Frm 00222 Fmt 4703 Sfmt 4703 Under the PRA of 1995, 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. 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. SUPPLEMENTARY INFORMATION: E:\FR\FM\30SEN1.SGM 30SEN1

Agencies

[Federal Register Volume 84, Number 189 (Monday, September 30, 2019)]
[Notices]
[Pages 51728-51729]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-21330]


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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

ADDRESSES: The 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 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 
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, Cost-Based and Inter-
Agency.
    Cost-Based rates apply to medical care and services that are 
provided by VA under Sec.  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 Sec.  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 Sec.  
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 Cost-Based 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.

------------------------------------------------------------------------
                                            Cost-based     Inter-agency
                                               rates           rates
------------------------------------------------------------------------
A. Hospital Care per inpatient day:
    General Medicine:
        All Inclusive Rate..............          $4,301          $4,156
        Physician.......................             515  ..............
        Ancillary.......................           1,121  ..............
        Nursing Room and Board..........           2,665  ..............
    Neurology:
        All Inclusive Rate..............           4,232           4,086
        Physician.......................             620  ..............
        Ancillary.......................           1,117  ..............
        Nursing Room and Board..........           2,495  ..............
    Rehabilitation Medicine:
        All Inclusive Rate..............           2,910           2,803
        Physician.......................             331  ..............
        Ancillary.......................             889  ..............
        Nursing Room and Board..........           1,690  ..............
    Blind Rehabilitation:
        All Inclusive Rate..............           1,995           1,920
        Physician.......................             161  ..............
        Ancillary.......................             991  ..............
        Nursing Room and Board..........             843  ..............
    Spinal Cord Injury:
        All Inclusive Rate..............           2,636           2,540
        Physician.......................             327  ..............
        Ancillary.......................             663  ..............
        Nursing Room and Board..........           1,646  ..............
    Surgery:
        All Inclusive Rate..............           7,526           7,272
        Physician.......................             829  ..............
        Ancillary.......................           2,283  ..............
        Nursing Room and Board..........           4,414  ..............
    General Psychiatry:
        All Inclusive Rate..............           2,174           2,091
        Physician.......................             205  ..............

[[Page 51729]]

 
        Ancillary.......................             342  ..............
        Nursing Room and Board..........           1,627  ..............
    Substance Abuse (Alcohol and Drug
     Treatment):
        All Inclusive Rate..............           2,232           2,147
        Physician.......................             213  ..............
        Ancillary.......................             516  ..............
        Nursing Room and Board..........           1,503  ..............
    Psychosocial Residential
     Rehabilitation Program:
        All Inclusive Rate..............             826             797
        Physician.......................              52  ..............
        Ancillary.......................              87  ..............
        Nursing Room and Board..........             687  ..............
    Intermediate Medicine:
        All Inclusive Rate..............           3,301           3,182
        Physician.......................             162  ..............
        Ancillary.......................             484  ..............
        Nursing Room and Board..........           2,655  ..............
    Poly-trauma Inpatient:
        All Inclusive Rate..............           3,223           3,097
        Physician.......................             366  ..............
        Ancillary.......................             985  ..............
        Nursing Room and Board..........           1,872  ..............
B. Nursing Home Care, Per Day:
    All Inclusive Rate..................           1,361           1,311
        Physician.......................              42  ..............
        Ancillary.......................             184  ..............
        Nursing Room and Board..........            1135  ..............
C. Outpatient Medical Treatments:
    Outpatient Visit (to include                     389             376
     Ineligible Emergency Dental Care)..
    Outpatient Physical Medicine &                   238             228
     Rehabilitation Service Visit.......
    Outpatient Poly-trauma/Traumatic                 671             649
     Brain Injury.......................
------------------------------------------------------------------------
Note: Outpatient Prescriptions will be billed at Drug Cost plus
  Administrative Fee.

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.

    Dated: September 26, 2019.
Jeffrey M. Martin,
Assistant Director, Office of Regulation Policy & Management, Office of 
the Secretary, Department of Veterans Affairs.
[FR Doc. 2019-21330 Filed 9-27-19; 8:45 am]
BILLING CODE 8320-01-P