Comment on DOD-2008-HA-0007-0001

I would encourage the rules to be revised to reflect 101% of cost without the limitation of lower of cost or charges. Many small rural CAH Hospitals cannot raise their charges high enough to cover costs so the rule as written will penalize those particular Hospitals. There is no mention of how Tricare will determine cost, i.e. cost settlement procedure, interim rate in lieu of settlement, etc. I believe this should be defined in the rule and be a simple settlement procedure based on as filed Medicare cost reports.