[Federal Register Volume 65, Number 202 (Wednesday, October 18, 2000)]
[Notices]
[Pages 62335-62336]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-26677]


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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 2001 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 2001 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 2001.

EFFECTIVE DATE: The fiscal year 2001 rates contained in this notice are 
effective for services occurring on or after October 1, 2000.

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 2001, Medicare has recommended a rate 
of increase of 3.4 percent for hospitals and units excluded from the 
prospective payment system. TRICARE will adopt this update factor for 
FY 2001 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 3.4 
percent for FY 2001. Partial hospitalization rates for full day and 
half day programs will also be updated by 3.4 percent for FY 2001. The 
cap amount for high volume hospitals and units will also be updated by 
the 3.4 percent for FY 2001. The beneficiary cost-share for low volume 
hospitals and units will also be updated by the 3.4 percent for FY 
2001. Consistent with Medicare, the wage portion of the regional rate 
subject to the area wage adjustment will be updated to 71.553 percent 
for FY 2001. The following reflect an update of 3.4 percent.

  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..............................................       $560
    Mid-Atlantic.............................................        537
Midwest:
    East North Central.......................................        464
    West North Central.......................................        438
South:
    South Atlantic...........................................        554
    East South Central.......................................        599
    West South Central.......................................        505
West:
    Mountain.................................................        504
    Pacific..................................................        594
@Wage portion of the rate, subject to the area wage               71.553
 adjustment..................................................    percent
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[[Page 62336]]

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 $149 per day or 25 percent of the hospital 
billed charges effective for services rendered on or after October 1, 
2000.
Cap Amount: Updated cap amount for hospitals and units with high 
TRICARE volume is $702 per day for FY 2001.
    The following reflect an update of 3.4 percent for FY 2001.

Partial Hospitalization Rates for Full-day and Half-day Programs FY 2001
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                                     Full-day rate (6  Half-day rate  (3-
    United States census region       hours or more)        5 hours)
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Northeast:
    New England (ME, NH, VT, MA,                 $225               $169
     RI, CT)......................
    Mid-Atlantic (NY, NJ, PA).....                242                182
Midwest:
    East North Central (OH, IN,                   213                160
     IL, MI, WI)..................
    West North Central (MN, IA,                   213                160
     MO, ND, SD, NE, KS)..........
South:
    South Atlantic (DE, MD, DC,                   231                173
     VA, WV, NC, SC, GA, FL)......
    East South Central (KY, TN,                   249                187
     AL, MS)......................
    West South Central (AR, LA,                   249                187
     TX, OK)......................
West:
    Mountain (MT, ID, WY, CO, NM,                 252                189
     AZ, UT, NV)..................
    Pacific (WA, OR, CA, AK, HI)..                246                185
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    The above rates are effective for services rendered on or after 
October 1, 2000.

    Dated: October 12, 2000.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense
[FR Doc. 00-26677 Filed 10-17-00; 8:45 am]
BILLING CODE 5001-10-P