[Federal Register Volume 62, Number 215 (Thursday, November 6, 1997)]
[Notices]
[Pages 60068-60069]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-29309]
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DEPARTMENT OF DEFENSE
Office of the Secretary
Proposed Collection; Comment Request
AGENCY: Office of the Assistant Secretary of Defense for Health
Affairs, DOD.
ACTION: Notice.
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In accordance with Section 3506(c)(2)(A) of the Paperwork Reduction
Act of 1995, the Office of the Assistant Secretary of Defense for
Health Affairs announces the proposed public information collection and
seeks public comment on the provisions thereof. Comments are invited
on: (a) whether the proposed collection of information is necessary for
the proper performance of the functions of the agency, including
whether the information shall have practical utility; (b) the accuracy
of the agency's estimate of the burden of the information collection;
(c) ways to enhance the quality, utility, and clarity of the
information to be collected; and (d) ways to minimize the burden of the
information collection on respondents, including through the use of
automated collection techniques or other forms of information
technology.
DATES: Consideration will be given to all comments received by January
5, 1998.
ADDRESSES: Written comments and recommendations on the information
collection should be sent to TRICARE Support Office, Program
Development Branch, U.S. Army Garrison, Fitzsimons, ATTN: Tariq Shahid,
Aurora, CO 80045-6900.
FOR FURTHER INFORMATION CONTACT:
To request more information on this proposed information collection,
please write to the above address or call TRICARE Support Office,
Program Development Branch, at (303) 361-1401.
Title; Associated Form; and OMB Number: Reimbursement Information,
Psychiatric Residential Treatment Centers Serving Children and
Adolescents, TRICARE Form 771, OMB Number 0704-0295.
Needs and Uses: The information collection requirement is necessary
to obtain individual residential treatment center (RTC) data that will
be used in calculating the prospective per diem rates for new RTCs
seeking certifications under the TRICARE program.
Affected Public: Business or other for-profit; non-profit
institutions.
Annual Burden Hours: 240.
Number of Respondents: 20.
Responses per Respondents: 1.
Average Burden per Response: 12 hours.
Frequency: On occasion.
SUPPLEMENTARY INFORMATION:
Summary of Information Collection
Respondents are psychiatric residential treatment centers (RTCs)
seeking certification under the TRICARE program to provide needed
services to eligible children and adolescents. The data collection
instrument, i.e., TRICARE Form 771, will collect the necessary
reimbursement information that will be used in calculating prospective
all-inclusive per diem rates for new RTCs under the TRICARE program.
Based on current trends, it is estimated that about 20 forms will be
completed and submitted to the TRICARE program per fiscal year for RTCs
seeking certification under the program.
The TRICARE Support Office (TSO), formerly known as OCHAMPUS,
published a proposed rule on 4 December 1987, (52 FR 46098), and final
rule on 1 August 1988, (53 FR 28873), in the Federal Register
clarifying participation requirements and establishing a new
reimbursement system for payment of RTCs. These amendments outlined the
methodology used in calculating the individual RTC rates along with the
capped amount. The amendments also described the data collection
elements and responded to 23 distinct categories of comments.
The TRICARE program will be responsible for: (1) sending out the
data collection instrument (TRICARE Form 771) to all RTCs seeking
certification under the TRICARE program; (2) answering all inquiries
regarding the data collection; (3) compiling and analyzing the
submitted data; (4) following up on missing or incomplete data; (5)
calculating the individual prospective all-inclusive per diem rates;
and (6) sending out RTC participation agreements with the calculated
rates.
The TRICARE's failure to collect the information will jeopardize
fulfillment of the program requirements and would result in the
agency's inability to collect the necessary data for establishment of
RTC rates. The agency's inability to establish prospective per diem
rates could also result in a reduction in availability of RTCs for
TRICARE beneficiaries.
The prospective payment methodology: (1) provides the potential for
control over rapidly increasing costs for mental health care within the
Department of Defense; (2) ensures that TRICARE beneficiaries are not
subject to exaggerated or unjustified costs for RTC care solely because
of the TRICARE entitlement; and (3) provides for a rate of
reimbursement for all participating RTCs which reflects a reasonable
amount consistent with rates charged by their peers nationally and with
reimbursement they are accepting from other third-party payers.
The use of improved information technology has been a consideration
in capturing RTC charge data necessary to calculate new rates; however,
this would create an excessive administrative burden on the agency for
the relatively small number of providers affected by the request. RTCs
represent less than 0.13 percent of TRICARE institutional providers and
less than 0.04 percent of TRICARE individual professional providers.
The agency would have to make major modifications to its payment
records and data files in order to retrieve this information.
In the data collection form design, we have made every effort to
eliminate any duplication. The form consists of two major categories of
data collection: (1) institutional per diem rates; and (2) additional
ancillary or professional charges not included in the per diem rates.
All data information systems have been queried to determine if there
was any duplication of data collection elements. None of the routine
data collection reports maintained by the agency have the information
formatted in a way that can be used to calculate the new RTC rates.
While TSO generates RTC reports, these reports do not include
professional claims which are billed separately from the institutional
component. Since the professional charges arenot married up with
institutional charges, an all-inclusive rate cannot be determined under
the existing reporting system. The marrying
[[Page 60069]]
up of claims would require extensive reprogramming of the current
payment system reports and would probably result in questionable data.
Even if TSO could modify its current reporting system, it would only
provide one of the data components necessary for establishing the RTC
rates. The rates for other third-party payers would remain inaccessible
under the TSO reporting system. Other third-party information is
critical in establishing the most favorable rate for the RTC. The RTC
is the only one that can provide other third-party information.
The data collection form is simplistic in design to minimize
administrative burden on the RTCs. The requested information should
already be maintained by the facility for normal operation. It is
anticipated that it should take one person 8 to 10 hours to prepare the
data, and an additional 2 to 4 hours if TRICARE should have follow-up
inquiries regarding their data submission. TSO or the TRICARE
contractor staff will be available to answer any questions that the
RTCs may have regarding completion of the form.
The issue of confidentiality has been considered. The data
submitted by RTCs will be kept in strict confidence and will not be
accessible to competitors. The only information accessible to the
general public will be the TRICARE all-inclusive rates calculated for
each RTC. These rates will appear in the TRICARE/CHAMPUS Policy Manual
and may be released under the Freedom of Information Act.
The information requested is financial in nature and may be
considered private or confidential in a business sense. Specific
knowledge of a RTC's financial position may create an unfair advantage
for its competitors. However, the information requested is necessary
for calculating the individual prospective all-inclusive per diem
rates. The RTCs are only being asked to provide those data (financial)
elements used directly in the reimbursement formula. They have also
been assured that facility specific information will be kept
confidential. The instruction sheet and cover letter will justify
collection of the information and give a detailed explanation of the
data element requirements.
The number of one-time respondents is 20. It is estimated that a
maximum of 12 hours will be required to complete the form since the
requested information should already be maintained by the facility for
normal operation. Most of the administrative burden will be associated
with the reformatting of existing financial information. The burden of
collecting the data will be dependent on the type of reporting system
in use. Facilities which maintain their financial records on computers
will be able to retrieve the requested information faster than those
with manual systems. The use of computerized data may cut the reporting
time in half (6 hours). Larger RTCs are more likely to have
sophisticated reporting systems than smaller facilities. However, this
is probably more the exception than the rule with the advent of more
reasonably priced ADP systems for small businesses. The total one-time
reporting burden is estimated to be 240 hours.
Dated: October 31, 1997.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 97-29309 Filed 11-5-97; 8:45 am]
BILLING CODE 5000-04-M
