Reasonable Charges for Medical Care or Services; v3.27 and National Average Administrative Prescription Drug Charge; Calendar Year 2020 Update, 69831-69832 [2019-27325]

Download as PDF Federal Register / Vol. 84, No. 244 / Thursday, December 19, 2019 / Notices DEPARTMENT OF THE TREASURY United States Mint Notification of Citizens Coinage Advisory Committee; Public Meeting Notification of Citizens Coinage Advisory Committee January 21, 2020, public meeting. ACTION: The United States Mint announces the Citizens Coinage Advisory Committee (CCAC) public meeting scheduled for January 21, 2020. Date: January 21, 2020. Time: 12:00 p.m. to 2:00 p.m. Location: 2nd Floor Conference Room A&B, United States Mint, 801 9th Street NW, Washington, DC 20220. Subject: Review and discussion of candidate designs for gold coins and silver and bronze medals commemorating the 75th anniversary of the end of World War II. Interested members of the public may either attend the meeting in person or dial in to listen to the meeting at (866) 564–9287/Access Code: 62956028. Interested persons should call the CCAC HOTLINE at (202) 354–7502 for the latest update on meeting time and room location. Any member of the public interested in submitting matters for the CCAC’s consideration is invited to submit them by email to info@ccac.gov. The CCAC advises the Secretary of the Treasury on any theme or design proposals relating to circulating coinage, bullion coinage, Congressional Gold Medals, and national and other medals; advises the Secretary of the Treasury with regard to the events, persons, or places to be commemorated by the issuance of commemorative coins in each of the five calendar years succeeding the year in which a commemorative coin designation is made; and makes recommendations with respect to the mintage level for any commemorative coin recommended. Members of the public interested in attending the meeting in person will be admitted into the meeting room on a first-come, first-serve basis as space is limited. Conference Room A&B can accommodate up to 50 members of the public at any one time. In addition, all persons entering a United States Mint facility must adhere to building security protocol. This means they must consent to the search of their persons and objects in their possession while on government grounds and when they enter and leave the facility, and are prohibited from bringing into the facility weapons of any type, illegal drugs, drug paraphernalia, or contraband. lotter on DSKBCFDHB2PROD with NOTICES SUMMARY: VerDate Sep<11>2014 19:13 Dec 18, 2019 Jkt 250001 The United States Mint Police Officer conducting the screening will evaluate whether an item may enter into or exit from a facility based upon Federal law, Treasury policy, United States Mint policy, and local operating procedure; and all prohibited and unauthorized items will be subject to confiscation and disposal. FOR FURTHER INFORMATION CONTACT: Jennifer Warren, United States Mint Liaison to the CCAC; 801 9th Street NW; Washington, DC 20220; or call 202–354– 7200. Authority: 31 U.S.C. 5135(b)(8)(C). Dated: December 13, 2019. David J. Ryder, Director, United States Mint. [FR Doc. 2019–27401 Filed 12–18–19; 8:45 am] BILLING CODE P DEPARTMENT OF VETERANS AFFAIRS Reasonable Charges for Medical Care or Services; v3.27 and National Average Administrative Prescription Drug Charge; Calendar Year 2020 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. SUMMARY: 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: Section (§ ) 17.101(a)(1) of 38 Code of Federal Regulations (CFR) sets forth the ‘‘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 for care) under a health plan contract; for a nonserviceconnected disability incurred incident to the veteran’s employment and PO 00000 Frm 00112 Fmt 4703 Sfmt 4703 69831 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(a)(2) provides that the actual charge amounts at individual VA medical 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 VA’s Community Care website at https://www.va.gov/ communitycare/revenue_ops/payer_ rates.asp. Certain charges are hereby updated as stated in this notice and will be effective on January 1, 2020. 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 Calendar Year (CY) 2020 HCPCS Level II and Current Procedural Terminology 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 E:\FR\FM\19DEN1.SGM 19DEN1 lotter on DSKBCFDHB2PROD with NOTICES 69832 Federal Register / Vol. 84, No. 244 / Thursday, December 19, 2019 / Notices this notice, the actual charge amounts at individual VA medical facilities based on the methodologies in § 17.101 will be posted on VA’s Community Care website at https://www.va.gov/ communitycare/revenue_ops/payer_ rates.asp under the heading ‘‘Reasonable Charges Data Tables’’ and identified as ‘‘v3.27 Data Tables (Outpatient and Professional).’’ The list of data sources used for calculating the actual charge amounts listed above also will be posted on VA’s Community Care website under the heading ‘‘Reasonable Charges Data Sources’’ and identified as ‘‘Reasonable Charges v3.27 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 84 FR 51727 published on September 30, 2019. 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 VA’s Community Care website under the heading ‘‘VA Medical Facility Locations’’ and identified as ‘‘v3.27 (Jan20).’’ 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 CY 2020 is $18.38. This change will be posted on VA’s Community Care website at https://www.va.gov/ COMMUNITYCARE/revenue_ops/ admin_costs.asp under the heading ‘‘CY 2020 Average Administrative Cost for Prescriptions.’’ Consistent with § 17.101, the national average administrative cost, the updated data, and supplementary tables VerDate Sep<11>2014 19:13 Dec 18, 2019 Jkt 250001 containing the changes described in this notice will be posted online, as indicated in this notice. This notice will be posted on VA’s Community Care website at https://www.va.gov/ communitycare/revenue_ops/payer_ rates.asp under the heading ‘‘Reasonable Charges Rules, Notices, and Federal Register’’ and identified as ‘‘v3.27 Federal Register Notice 01/01/20 (Outpatient and Professional), and National Average 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 FR notice. 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. Pamela Powers, Chief of Staff, Department of Veterans Affairs, approved this document on December 12, 2019, for publication. Jeffrey M. Martin, Assistant Director, Office of Regulation Policy & Management, Office of the Secretary, Department of Veterans Affairs. [FR Doc. 2019–27325 Filed 12–18–19; 8:45 am] BILLING CODE 8320–01–P DEPARTMENT OF VETERANS AFFAIRS Veterans and Community Oversight and Engagement Board, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act the Veterans and Community Oversight and Engagement Board will meet on January 15–16, 2020 at 11301 Wilshire Boulevard, Building 500, Room 1281, Los Angeles, CA. The meeting sessions will begin and end as follows: Date Time January 15, 2020 ... 8:00 a.m. to 5:00 p.m.—Pacific Standard Time (PST). 8:00 a.m. to 5:00 p.m.—PST. January 16, 2020 ... The meeting sessions are open to the public. The Board was established by the West Los Angeles Leasing Act of 2016 on September 29, 2016. The purpose of the Board is to provide advice and make recommendations to the Secretary of Veterans Affairs on: Identifying the PO 00000 Frm 00113 Fmt 4703 Sfmt 9990 goals of the community and Veteran partnership; improving services and outcomes for Veterans, members of the Armed Forces, and the families of such Veterans and members; and on the implementation of the Draft Master Plan approved by the Secretary on January 28, 2016, and on the creation and implementation of any successor master plans. On Wednesday, January 15, 2020, the agenda will include briefings from senior VA officials, to include comprehensive status update from the West Los Angeles Collective, on infrastructure assessment, housing metrics, reporting requirements, and topics related to the Overall Community Plan. The Board will receive an informative briefing from Operation Fire for Effect representatives on a proposed Framework of the Principles of the Veterans Master Plan. A public comment session will occur from 3:30 p.m. to 4:30 p.m. followed by a wrap up of Public Comment session. On Thursday, January 16, 2020, the Board will receive additional briefings from the VA Boston Healthcare System on Moral Injury. A comprehensive review and analysis briefing on the Homeless Gap Analysis in Los Angeles will be provided by both the Community Engagement and Reintegration Services team form VA Greater Los Angeles Healthcare System (VALAHS) and the Los Angeles Homeless Services Authority (LAHSA). The Board’s subcommittees on Outreach and Community Engagement with Services and Outcomes, and Master Plan with Services and Outcomes will meet to finalize reports on activities since the last meeting, followed by an out brief to the full Board and update on draft recommendations considered for forwarding to the SECVA. Individuals wishing to make public comments should contact Chihung Szeto at (562) 708–9959 or at Chihung.Szeto@va.gov and are requested to submit a 1–2-page summary of their comments for inclusion in the official meeting record. In the interest of time, each speaker will be held to 5-minute time limit. Any member of the public seeking additional information should contact Mr. Eugene W. Skinner Jr. at (202) 631– 7645 or at Eugene.Skinner@va.gov. Dated: December 16, 2019. Jelessa M. Burney, Federal Advisory Committee Management Officer. [FR Doc. 2019–27388 Filed 12–18–19; 8:45 am] BILLING CODE P E:\FR\FM\19DEN1.SGM 19DEN1

Agencies

[Federal Register Volume 84, Number 244 (Thursday, December 19, 2019)]
[Notices]
[Pages 69831-69832]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-27325]


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DEPARTMENT OF VETERANS AFFAIRS


Reasonable Charges for Medical Care or Services; v3.27 and 
National Average Administrative Prescription Drug Charge; Calendar Year 
2020 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, 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: Section (Sec.  ) 17.101(a)(1) of 38 Code of 
Federal Regulations (CFR) 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(a)(2) provides that the actual charge amounts at 
individual VA medical 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 VA's Community Care website at https://www.va.gov/communitycare/revenue_ops/payer_rates.asp.
    Certain charges are hereby updated as stated in this notice and 
will be effective on January 1, 2020.
    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 Calendar Year (CY) 2020 HCPCS Level 
II and Current Procedural Terminology 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

[[Page 69832]]

this notice, the actual charge amounts at individual VA medical 
facilities based on the methodologies in Sec.  17.101 will be posted on 
VA's Community Care website at https://www.va.gov/communitycare/revenue_ops/payer_rates.asp under the heading ``Reasonable Charges Data 
Tables'' and identified as ``v3.27 Data Tables (Outpatient and 
Professional).''
    The list of data sources used for calculating the actual charge 
amounts listed above also will be posted on VA's Community Care website 
under the heading ``Reasonable Charges Data Sources'' and identified as 
``Reasonable Charges v3.27 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 84 FR 
51727 published on September 30, 2019.
    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 VA's Community Care website under the 
heading ``VA Medical Facility Locations'' and identified as ``v3.27 
(Jan20).''
    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 CY 2020 is $18.38. This 
change will be posted on VA's Community Care website at https://www.va.gov/COMMUNITYCARE/revenue_ops/admin_costs.asp under the heading 
``CY 2020 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 VA's Community Care website at 
https://www.va.gov/communitycare/revenue_ops/payer_rates.asp under the 
heading ``Reasonable Charges Rules, Notices, and Federal Register'' and 
identified as ``v3.27 Federal Register Notice 01/01/20 (Outpatient and 
Professional), and National Average 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 FR notice.

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. Pamela Powers, 
Chief of Staff, Department of Veterans Affairs, approved this document 
on December 12, 2019, for publication.

Jeffrey M. Martin,
Assistant Director, Office of Regulation Policy & Management, Office of 
the Secretary, Department of Veterans Affairs.
[FR Doc. 2019-27325 Filed 12-18-19; 8:45 am]
 BILLING CODE 8320-01-P