[Federal Register Volume 85, Number 243 (Thursday, December 17, 2020)]
[Notices]
[Page 82034]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-27804]


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DEPARTMENT OF VETERANS AFFAIRS


Reasonable Charges for the National Average Administrative 
Prescription Drug Charge Calendar Year (CY) 2021 Update

AGENCY: Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: This Department of Veterans Affairs (VA) notice identifies the 
website where updates to the National Average Administrative 
Prescription Charge is located for purposes of calculating VA's costs 
for prescription drugs not administered during treatment, but provided 
or furnished by VA.

DATES: This adjustment is effective January 1, 2021.

FOR FURTHER INFORMATION CONTACT: Ms. Romona Greene, Office of Community 
Care (OCC), Revenue Operations, Payer Relations and Services, Rates and 
Charges (13RO1), Veterans Health Administration, Department of Veterans 
Affairs, 810 Vermont Avenue NW, Washington, DC 20420. The telephone 
number is 202-382-2521 (this is not a toll-free number).

SUPPLEMENTARY INFORMATION: Section 17.101(m) of title 38 CFR 
establishes the charges for prescription drugs not administered during 
treatment, as part of medical care or services provided or furnished by 
VA to a Veteran under 38 CFR 17.101(a)(1) for a nonservice-connected 
disability for which the Veteran is entitled to care (or the payment of 
expenses for care) under a health plan contract; for a nonservice-
connected disability incurred incident to the Veteran's employment and 
covered under a worker's compensation law or plan that provides 
reimbursement or indemnification for such care and services; or for a 
nonservice-connected disability incurred as a result of a motor vehicle 
accident in a state that requires automobile accident reparations 
insurance.
    As indicated in 38 CFR 17.101(m), when VA provides or furnishes 
prescription drugs not administered during treatment, within the scope 
of care described in section 17.101(a)(1), charges billed separately 
for such prescription drugs will consist of the amount that equals the 
total of the actual cost to VA for the drugs and the national average 
of VA administrative costs associated with dispensing the drugs for 
each prescription. Section 17.101(m) further describes the methodology 
for calculating the national average administrative cost for 
prescription drug charges not administered during treatment.
    VA determines the amount of the national average administrative 
cost annually for the prior fiscal year (October through September) and 
then applies the charge at the start of the next calendar year.
    Consistent with section 17.101(a)(2), the national average 
administrative cost calculated by VA under section 17.101(m) will be 
posted online on VA's OCC website at https://www.va.gov/communitycare/revenue_ops/payer_rates.asp under the heading ``Reasonable Charges 
Rules, Notices, and Federal Register and identified as CY 21 National 
Average Administrative Cost (PDF)'', to be effective on January 1, 
2021. The national average administrative cost posted will be effective 
until changed by a subsequent Federal Register notice.

Signing Authority

    The Secretary of Veterans Affairs, or designee, approved this 
document and authorized the undersigned to sign and submit the document 
to the Office of the Federal Register for publication electronically as 
an official document of the Department of Veterans Affairs. Brooks D. 
Tucker, Assistant Secretary for Congressional and Legislative Affairs, 
performing the delegable duties of the Chief of Staff, approved this 
document on December 10, 2020 for publication.

Jeffrey M. Martin,
Assistant Director, Office of Regulation Policy & Management, Office of 
the Secretary, Department of Veterans Affairs.
[FR Doc. 2020-27804 Filed 12-16-20; 8:45 am]
BILLING CODE 8320-01-P