[Federal Register Volume 69, Number 4 (Wednesday, January 7, 2004)]
[Notices]
[Page 1062]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-317]



  Federal Register / Vol. 69, No. 4 / Wednesday, January 7, 2004 / 
Notices  

[[Page 1062]]


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OFFICE OF MANAGEMENT AND BUDGET


Charges to Tortiously Liable Third Parties for Hospital, Medical, 
Surgical, and Dental Care and Treatment Furnished by the United States 
(Department of Veterans Affairs)

AGENCY: Office of Management and Budget, Executive Office of the 
President.

ACTION: Notification of charges to tortiously liable third parties for 
hospital, medical, surgical, and dental care and treatment furnished by 
the Department of Veterans Affairs.

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SUMMARY: By virtue of the authority vested in the President by section 
2(a) of the Federal Medical Care Recovery Act, Public Law 87-693 (76 
Stat. 593; 42 U.S.C. 2652), and delegated to the Director of the Office 
of Management and Budget by Executive Order No. 11541 of July 1, 1970 
(35 FR 10737), the charges to tortiously liable third parties for 
hospital, medical, surgical, and dental care and treatment (including 
prostheses and medical appliances) furnished by the Department of 
Veterans Affairs are the ``reasonable charges'' generated by the 
methodology set forth in 38 CFR 17.101 and published from time to time 
in the Federal Register, most recently on April 29, 2003 (68 FR 22774). 
These charges are for use in connection with the recovery from 
tortiously liable third persons of the reasonable value of hospital, 
medical, surgical, and dental care and treatment furnished by the 
United States through the Department of Veterans Affairs (28 CFR 43.1-
43.4). These charges have been established in accordance with the 
requirements of OMB Circular A-25, which requires charges that are at 
least as great as the full cost of the services provided
    There are two basic reasons for this change. First, VA's community-
based ``reasonable charges'' more accurately reflect the reasonable 
value of the medical care and treatment furnished by VA to the injured 
person, consistent with 42 U.S.C. 2651 and 2652, than do VA's cost-
based per-diem tort rates.
    Second, VA's present dual-rate billing system (tort feasor and 
health plan), using significantly different charges, is confusing and 
difficult to justify. VA claims, for example, may be made both against 
the tort feasor who caused the injury, using the current FMCRA per-diem 
rates, and against the veteran's health plan, using the significantly 
higher reasonable charges, for the same VA medical care. This not only 
is confusing to VA billing officials and makes settling claims more 
difficult, but such dual billing also may disadvantage veterans by 
providing a per-diem rate bill to assert against the tort feasor while 
exposing veterans to subrogation claims from their health plans who 
paid at the higher reasonable charges rates. Making the charges billed 
to all liable parties in FMCRA cases uniform will eliminate confusion 
and remove an impediment to allowing injured veterans to assert the 
higher reasonable charges rates for their causally related health care 
as a necessary and proper element of damages in their cases against the 
responsible tort feasors.
    Beginning on January 7, 2004, the charges prescribed herein 
supercede those established by the Director of the Office of Management 
and Budget for the Department of Veterans Affairs on November 1, 1999 
(64 FR 58862).

Joshua B. Bolten,
Director.
[FR Doc. 04-317 Filed 1-6-04; 8:45 am]
BILLING CODE 3110-01-P