[Federal Register Volume 86, Number 174 (Monday, September 13, 2021)]
[Notices]
[Page 50953]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-19658]



[[Page 50953]]

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DEPARTMENT OF VETERANS AFFAIRS


Reasonable Charges for Inpatient Medical Severity-Diagnosis 
Related Groups and Skilled Nursing Facility Medical Services (v4.22); 
Fiscal Year 2022 Update

AGENCY: Department of Veterans Affairs (VA).

ACTION: Notice.

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SUMMARY: This document updates the acute inpatient and Skilled Nursing 
Facility (SNF)/sub-acute inpatient facility charges. The updated 
charges are based on Medical Severity-Diagnosis Related Groups (MS-DRG) 
for fiscal year (FY) 2022.

FOR FURTHER INFORMATION CONTACT: Debra Vatthauer, Office of Community 
Care, Revenue Operations, Payer Relations and Services, Rates and 
Charges (13RO1), Veterans Health Administration, Department of Veterans 
Affairs, 128 Bingham Road, Suite 1000, Asheville, NC 28806; email: 
[email protected]; telephone: 608-821-7346 (This is not a toll-
free number.)

SUPPLEMENTARY INFORMATION: 38 CFR 17.101(a)(1) sets forth VA's 
collection or recovery regulations for medical care or services 
provided or furnished by VA to a Veteran for a nonservice-connected 
disability for which the Veteran is entitled to care (or the payment of 
expenses of 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. The methodologies for establishing billed amounts for 
several types of charges are found in 38 CFR 17.101; however, this 
notice will only address the acute inpatient and the SNF/sub-acute 
inpatient facility charges.
    Based on the methodologies set forth in 38 CFR 17.101(b), this 
notice updates the acute inpatient facility charges that were based on 
the FY 2021 MS-DRGs. Acute inpatient facility charges by MS-DRGs are 
posted on the Veterans Health Administration (VHA) Office of Community 
Care (OCC) website, at the following link: www.va.gov/communitycare/revenue_ops/payer_rates.asp, under the ``Reasonable Charges Data 
Tables'' section, Inpatient Data Table, as Table A (v4.21). This Table 
A corresponds to the Table A referenced in a notice published in the 
Federal Register on September 22, 2020 (see 85 FR 59606). Table A 
(v4.22) referenced in this notice provides updated charges based on the 
FY 2022 MS-DRGs and will replace Table A (v4.21) posted on the VHA OCC 
website.
    Also, this notice updates the SNF/sub-acute inpatient facility all-
inclusive per diem charge using the methodologies set forth in 38 CFR 
17.101(c). This charge is adjusted by a geographic area factor that is 
based on the location where the care is provided. For the geographic 
area factors, see Table N, title ``Acute Inpatient,'' and Table O, 
title ``SNF,'' on the VHA OCC website under the v4.215 link in the 
``Reasonable Charges Data Tables'' section. Tables N and O are not 
being updated by this notice. The SNF/sub-acute inpatient facility per 
diem charge is posted on the VHA OCC website under the ``Reasonable 
Charges Data Tables'' section, Table B (v4.21). This Table B 
corresponds to the Table B referenced in a notice published in the 
Federal Register on September 22, 2020 (see 85 FR 59606). Table B 
referenced in this notice is v4.22, which provides an update to the 
all-inclusive nationwide SNF/sub-acute inpatient facility per diem 
charge and will replace Table B (v4.21) posted on the VHA OCC website.
    The charges in this notice for acute inpatient and SNF/sub-acute 
inpatient facility services are effective October 1, 2021.
    This notice is retaining the table designations used for acute 
inpatient facility charges by MS-DRGs, which are posted on the VHA OCC 
website under ``Reasonable Charges Data Tables.'' This notice also is 
retaining the table designation used for SNF/sub-acute inpatient 
facility charges, which also are posted on the VHA OCC website. 
Accordingly, the tables identified as being updated by this notice 
correspond to the applicable tables referenced in a notice published in 
the Federal Register on September 22, 2020 (see 85 FR 59606).
    The list of data sources presented in Supplementary Table 1 (v4.22) 
reflects the updated data sources used to establish the updated charges 
described in this notice and will be posted on the VHA OCC website 
under the ``Reasonable Charges Data Sources'' section.
    The list of VA medical facility locations is also updated. In 
Supplement Table 3, posted on the VHA OCC website under the VA Medical 
Facility Locations section, VA set forth the list of VA medical 
facility locations, which includes the first three digits of their zip 
codes and provider-based/non-provider-based designations.
    Consistent with VA's regulations, the updated tables described in 
this notice will be posted on the VHA OCC website, under the ``Payer 
Rates and Charges'' information section.

Signing Authority

    Denis McDonough, Secretary of Veterans Affairs, approved this 
document on August 16, 2021, 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.

Luvenia Potts,
Regulation Development Coordinator, Office of Regulation Policy & 
Management, Office of General Counsel, Department of Veterans Affairs.
[FR Doc. 2021-19658 Filed 9-10-21; 8:45 am]
BILLING CODE 8320-01-P