[Federal Register Volume 66, Number 202 (Thursday, October 18, 2001)]
[Notices]
[Pages 52896-52897]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-26239]


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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 2002 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 2002 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 2002.

EFFECTIVE DATE: The fiscal year 2002 rates contained in this notice are 
effective for services occurring on or after October 1, 2001.

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 2002, Medicare has 
recommended a rate of increase of 3.3 percent for hospitals and units 
excluded from the prospective payment system. TRICARE will adopt this 
update factor for FY 2002 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 
2001 updated by 3.3 percent for FY 2002. Partial hospitalization rates 
for full day and half day programs will also be updated by 3.3 percent 
for FY 2002. The cap amount for high volume hospitals and units will 
also be updated by the 3.3 percent for FY 2002. The beneficiary cost-
share for low volume hospitals and units will also be updated by the 
3.3 percent for FY 2002.
    Consistent with Medicare, the wage portion of the regional rate 
subject to the area wageadjustment will remain at 71.553 percent for FY 
2002. The following reflect an update of 3.3 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............................................         $578
    Mid-Atlantic...........................................          555
Midwest:
    East North Central.....................................          479
    West North Central.....................................          452
South:
    South Atlantic.........................................          572
    East South Central.....................................          619
    West South Central.....................................          522
West:
    Mountain...............................................          521
    Pacific................................................          614
@Wage portion of the rate, subject to the area wage               71.553
 adjustment (in percent)...................................
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[[Page 52897]]

    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 $154 per day or 25 percent of 
the hospital billed charges effective for services rendered on or after 
October 1, 2001
    Cap Amount: Updated cap amount for hospitals and units with high 
TRICARE volume is $725 per day for FY 2002.
    The following reflect an update of 3.3 percent for FY 2002.

Partial Hospitalization Rates for Full-Day and Half-Day Programs FY 2002
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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,               $232             $175
     CT)..............................
    Mid-Atlantic (NY, NJ, PA).........              250              188
Midwest:
    East North Central (OH, IN, IL,                 220              165
     MI, WI)..........................
    West North Central (MN, IA, MO,                 220              165
     ND, SD, NE, KS)..................
South:
    South Atlantic (DE, MD, DC, VA,                 239              179
     WV, NC, SC, GA, FL)..............
    East South Central (KY, TN, AL,                 257              193
     MS)..............................
    West South Central (AR, LA, TX,                 257              193
     OK)..............................
West:
    Mountain (MT, ID, WY, CO, NM, AZ,               260              195
     UT, NV)..........................
    Pacific (WA, OR, CA, AK, HI)......              254              191
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    The above rates are effective for services rendered on or after 
October 1, 2001.

    Dated: October 12, 2001.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 01-26239 Filed 10-12-01; 8:45 am]
BILLING CODE 5001-08-P