[Federal Register Volume 77, Number 74 (Tuesday, April 17, 2012)]
[Notices]
[Page 22770]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-9146]


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DEPARTMENT OF DEFENSE

Office of the Secretary


Termination of Provider Reimbursement Demonstration Project for 
the State of Alaska

AGENCY: Department of Defense (DoD).

ACTION: Notice of demonstration termination.

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SUMMARY: This notice provides a termination of the demonstration 
project in the State of Alaska for individual provider payment rates. 
Under the demonstration, payment rates for physicians and other non-
institutional individual professional providers in the State of Alaska 
have been set at a rate higher than the Medicare rate. The goal of the 
demonstration was to determine at what rate payment would need to be 
set in order to encourage higher participation in the TRICARE program 
by providers in Alaska.

DATES: The demonstration regarding payment rates for physicians and 
other non-institutional providers is terminated effective May 17, 2012.

ADDRESSES: TRICARE Management Activity (TMA), Medical Benefits and 
Reimbursement Branch, 16401 East Centretech Parkway, Aurora, CO 80011-
9066.

FOR FURTHER INFORMATION CONTACT: Glenn J. Corn, TRICARE Management 
Activity, Medical Benefits and Reimbursement Branch, telephone (303) 
676-3566.

SUPPLEMENTARY INFORMATION: On November 20, 2006 (71 FR 67113), DoD 
published a Notice of a TRICARE demonstration project for the State of 
Alaska, with an effective date of January 1, 2007. The demonstration 
set payment rates for physicians and other non-institutional individual 
professional providers in the State of Alaska at a rate higher than the 
Medicare rate in order to determine if more individual providers would 
participate in the TRICARE program. The demonstration was effective 
January 1, 2007 for a period of three years, ending on December 31, 
2009. The demonstration was extended twice. On December 18, 2009 (74 FR 
67179), DoD published a Notice of demonstration extension that extended 
the demonstration through December 31, 2010, and on July 8, 2010 (75 FR 
39213), DoD published a Notice of demonstration extension that extended 
the demonstration through December 31, 2012.
    An analysis of the effectiveness of the demonstration was conducted 
and it showed an increase in provider participation. This increased 
participation opened access to local specialty care that had previously 
been severely impaired, and it decreased the overall cost of health 
care by reducing the travel costs incurred by the Department for Prime 
beneficiaries who had been forced to travel long distances to receive 
care outside of Alaska. The demonstration also showed that each 
geographic area in Alaska had increased participation using the same 
``multiplier'' of the Medicare rate. Thus in order to preserve the 
successes made through the demonstration project in improving provider 
access and to keep the CHAMPUS Maximum Allowable Charge rates in 
relative proportion with the demonstration rates, the Department has 
determined that it can use its current authority under Title 10, United 
States Code, section 1079(h)(5) to provide a state-wide locality based 
reimbursement waiver without requesting additional statutory or 
regulatory authority for the State of Alaska. A state-wide locality 
based waiver was approved by the Director of TMA under current 
authority (Title 32, Code of Federal Regulations, section 
199.14(j)(1)(iv)(D)) on September 15, 2011, and thus the need for this 
demonstration has ceased. This state-wide locality based reimbursement 
waiver allows the higher individual provider payment rates associated 
with the demonstration project.

    Dated: March 30, 2012.
Patricia Toppings,
OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2012-9146 Filed 4-16-12; 8:45 am]
BILLING CODE 5001-06-P