[Federal Register Volume 72, Number 189 (Monday, October 1, 2007)]
[Notices]
[Pages 55751-55752]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 07-4829]


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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 (FY) 2008 
Mental Health Rate Updates

AGENCY: Department of Defense.

ACTION: Notice of updated mental health per diem rates.

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SUMMARY: This notice provides for the updating of institution-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 2008 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 FY 2008.

DATES: Effective Date: The FY 2008 rates contained in this notice are 
effective for services occurring on or after October 1.

FOR FURTHER INFORMATION CONTACT: Christine Covie, Office of Medical 
Benefits and Reimbursement Systems, TRICARE Management Activity, 
telephone (303) 676-3841.

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 FY. 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 2008, 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 2008 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 2007 updated by 3.4 
percent for FY 2008. Partial hospitalization rates for full-day and 
half-day programs will also be updated by 3.4 percent for FY 2008. The 
cap amount for high-volume hospitals and units will also be updated by 
the 3.4 percent for FY 2008. The beneficiary cost share for low volume 
hospitals and units will also be updated by the 3.4 percent for FY 
2008.
    Consistent with Medicare, the wage portion of the regional rate 
subject to the area wage adjustment is 75.788 percent for FY 2008. The 
following reflect an update of 3.4 percent for FY 2008.

Regional Specific Rates for Psychiatric Hospitals and Units With Low 
TRICARE Volume

                       United States Census Region
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                                                                 Rate @
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Northeast:
    New England..............................................       $707
    Mid-Atlantic.............................................        681
Midwest:
    East North Central.......................................        588
    West North Central.......................................        555
South:
    South Atlantic...........................................        701
    East South Central.......................................        750
    West South Central.......................................        639
West:
    Mountain.................................................        638
    Pacific..................................................        754
    Puerto Rico..............................................        481
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@ Wage portion of the rate, subject to the area wage adjustment--75.788.

    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 $187 per day or 25 percent of 
the hospital billed charges effective for services rendered on or after 
October 1, 2007.
    Cap Amount: Updated cap amount for hospitals and units with high 
TRICARE volume is $889 per day for FY 2008.
    The following reflect an update of 3.4 percent for FY 2008.

    Partial Hospitalization Rates for Full-Day and Half-Day Programs
                           [Fiscal year 2007]
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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 (Maine, N.H., Vt.,               $284               $214
     Mass., R.I., Conn.)..........
Mid-Atlantic:
    (N.Y., N.J., Penn.)...........                308                232
Midwest:
    East North Central (Ohio,                     271                203
     Ind., Ill., Mich., Wis.).....
West North Central:
    (Minn., Iowa, Mo., N.D., S.D.,                271                203
     Neb., Kan.)..................
South:
    South Atlantic (Del., Md.,                    292                219
     D.C., Va., W.Va., N.C., S.C.,
     Ga., Fla.)...................
East South Central:
    (Ky., Tenn., Aa., Miss.)......                315                237
West South Central:
    (Ark., La., Texas, Okla.).....                315                237
West:
    Mountain (Mon., Idaho, Wyo.,                  318                240
     Col., N.M., Ariz., Utah,
     Nev.)........................
    Pacific (Wash., Ore., Calif.,                 312                234
     Alaska, Hawaii)..............
Puerto Rico.......................                203                153
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[[Page 55752]]

    The above rates are effective for services rendered on or after 
October 1, 2007.

    Dated: September 25, 2007.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 07-4829 Filed 9-28-7; 8:45 am]
BILLING CODE 5001-06-M