[Federal Register Volume 64, Number 168 (Tuesday, August 31, 1999)]
[Notices]
[Pages 47487-47488]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-22567]
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DEPARTMENT OF DEFENSE
Office of the Secretary
TRICARE Formerly Known as the Civilian Health and Medical Program
of the Uniformed Services (CHAMPUS); Fiscal Year 2000 Mental Health
Rate Updates
AGENCY: Office of the Secretary, DoD.
ACTION: Notice of updated mental health per diem rates.
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SUMMARY: This notice provides for the updating of hospital-specific per
diem rates for high volume providers and regional per diem rates for
low volume providers; the updated cap per diem for high volume
providers; the beneficiary per diem cost-share amount for low volume
providers for FY 2000 under the TRICARE Mental Health Per Diem Payment
System; and the updated per diem rates for both full-day and half-day
TRICARE Partial Hospitalization Programs for fiscal year 2000. It also
corrects partial hospitalization per diem rates for fiscal year 1999
that were published September 28, 1998.
EFFECTIVE DATE: The fiscal year 2000 rates contained in this notice are
effective for services occurring on or after October 1, 1999.
FOR FURTHER INFORMATION CONTACT: Stan Regensberg, Office of Medical
Benefits and Reimbursement Systems, TRICARE Management Activity,
telephone (303) 676-3742.
SUPPLEMENTARY INFORMATION: The final rule published in the Federal
Register on September 6, 1988, (53 FR 34285) set forth reimbursement
changes that were effective for all inpatient hospital admissions in
psychiatric hospitals and exempt psychiatric units occurring on or
after January 1, 1989. The final rule published in the Federal Register
on July 1, 1993, (58 FR 35-400) set forth maximum per diem rates for
all partial hospitalization admissions on or after September 29, 1993.
Included in these final rules were provisions for updating
reimbursement rates for each federal fiscal year. As stated in the
final rules, each per diem shall be updated by the Medicare update
factor for hospitals and units exempt from the Medicare Prospective
Payment System. For fiscal year 2000, Medicare has recommended a rate
of increase of 2.9 percent for hospitals and units excluded from the
prospective payment system. TRICARE will adopt this update factor for
FY 2000 as the final update factor. Hospitals and units with hospital-
specific rates (hospitals and units with high TRICARE volume) and
regional specific rates for psychiatric hospitals and units with low
TRICARE volume will have their TRICARE rates for FY 2000 updated by 2.9
percent for FY 2000. Partial hospitalization rates for full day and
half day programs will also be updated by 2.9 percent for FY 2000. The
cap amount for high volume hospitals and units will also be updated by
the 2.9 percent for FY 2000. The beneficiary cost-share of low volume
hospitals and units will also be updated by the 2.9 percent for FY
2000. Consistent with Medicare, the wage portion of the regional rate
subject to the area wage adjustment will remain at 71.1 percent for FY
2000.
The following reflect an update of 2.9 percent.
[[Page 47488]]
Regional Specific Rates for Psychiatric Hospitals and Units with Low
Tricare Volume
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United States census region Rate@
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Northeast:
New England................................................ $542
Mid-Atlantic............................................... 519
Midwest:
East North Central......................................... 449
West North Central......................................... 424
South:
South Atlantic............................................. 536
East South Central......................................... 579
West South Central......................................... 488
West:
Mountain................................................... 487
Pacific.................................................... 574
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@ Wage portion of the rate, subject to the area wage adjustment--71.1
percent
Beneficiary Cost-Share: Beneficiary cost-share (other than
dependents of active duty members) for care paid on the basis of a
regional per diem rate is the lower of $144 per day or 25 percent of
the hospital billed charges effective for services rendered on or after
October 1, 1999.
Cap Amount: Updated cap amount for hospitals and units with high
TRICARE volume is $679 per day for FY 2000.
The following reflect an update of 2.9 percent for FY 2000.
Partial Hospitalization Rates For Full-Day and Half-Day Programs FY 2000
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Full-day rate
United States census region (6 hours or Half-day rate
more) (3-5 hours)
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Northeast:
New England (ME, NH, VT, MA, RI, CT) $218 $164
Mid-Atlantic (NY, NJ, PA)........... 234 176
Midwest:
East North Central (OH, IN, IL, MI, 206 155
WI)................................
West North Central (MN, IA, MO, ND, 206 155
SD, NE, KS)........................
South:
South Atlantic (DE, MD, DC, VA, WV, 223 167
NC, SC, GA, FL)....................
East South Central (KY, TN, AL, MS). 241 181
West South Central (AR, LA, TX, OK). 241 181
West:
Mountain (MT, ID, WY, CO, NM, AZ, 244 183
UT, NV)............................
Pacific (WA, OR, CA, AK, HI)........ 238 179
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The following reflect a correction to the partial hospitalization
rates for FY 1999.
Partial Hospitalization Rates For Full-Day and Half-Day Programs FY 1999
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Full-day rate
United States census region (6 hours or Half-day rate
more) (3-5 hours)
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Northeast:
New England (ME, NH, VT, MA, RI, CT) $212 $159
Mid-Atlantic (NY, NJ, PA)........... 227 170
Midwest:
East North Central (OH, IN, IL, MI, 200 150
WI)................................
West North Central (MN, IA, MO, ND, 200 150
SD, NE, KS)........................
South:
South Atlantic (DE, MD, DC, VA, WV, 217 163
NC, SC, GA, FL)....................
East South Central (KY, TN, AL, MS). 234 176
West south Central (AR, LA, TX, OK). 234 176
West:
Mountain (MT, ID, WY, CO, NM, AZ, 237 178
UT, NV)............................
Pacific (WA, OR, CA, AK, HI)........ 231 173
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These partial hospitalization rates are the new calculated rates
that reflect the 2.4 percent increase for FY 1999. The FY 2000, 2.9
percent increase, effective October 1, 1999, is applied to these new
calculated rates.
Dated: August 25, 1999.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 99-22567 Filed 8-30-99; 8:45 am]
BILLING CODE 5001-10-M
