81 FR 90410 - Reasonable Charges for Medical Care or Services; v3.21, 2017 Calendar Year Update and National Average Administrative Prescription Drug Charge Update

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 81, Issue 240 (December 14, 2016)

Page Range		90410-90411
FR Document		2016-30008

This Department of Veterans Affairs (VA) notice updates the data for calculating the ``Reasonable Charges'' collected or recovered by VA for medical care or services. This notice also updates the ``National Average Administrative Prescription Costs'' for purposes of calculating VA's charges for prescription drugs that were not administered during treatment, but provided or furnished by VA to a veteran.

Federal Register, Volume 81 Issue 240 (Wednesday, December 14, 2016)

[Federal Register Volume 81, Number 240 (Wednesday, December 14, 2016)]
[Notices]
[Pages 90410-90411]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-30008]


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DEPARTMENT OF VETERANS AFFAIRS


Reasonable Charges for Medical Care or Services; v3.21, 2017 
Calendar Year Update and National Average Administrative Prescription 
Drug Charge Update

AGENCY: Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: This Department of Veterans Affairs (VA) notice updates the 
data for calculating the ``Reasonable Charges'' collected or recovered 
by VA for medical care or services. This notice also updates the 
``National Average Administrative Prescription Costs'' for purposes of 
calculating VA's charges for prescription drugs that were not 
administered during treatment, but provided or furnished by VA to a 
veteran.

FOR FURTHER INFORMATION CONTACT: Romona Greene, Office of Community 
Care, Revenue Operations, Consolidated Patient Account Center (CPAC) 
Rates and Charges (10D1C), Veterans Health Administration (VHA), 
Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 
20420, (202) 382-2521. This is not a toll free number.

SUPPLEMENTARY INFORMATION: Section 17.101 of 38 Code of Federal 
Regulations sets forth the ``Reasonable Charges'' 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 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.'' Section 17.101 provides the methodologies for 
establishing billed amounts for several types of charges; however, this 
notice will only address partial hospitalization facility charges; 
outpatient facility charges; physician and other professional charges, 
including professional charges for anesthesia services and dental 
services; pathology and laboratory charges; observation care facility 
charges; ambulance and other emergency transportation charges; and 
charges for durable medical equipment, drugs, injectables, and other 
medical services, items, and supplies identified by Healthcare Common 
Procedure Coding System (HCPCS) Level II codes.
    Section 17.101 provides that the actual charge amounts at 
individual VA facilities based on these methodologies and the data 
sources used for calculating those actual charge amounts will either be 
published as a notice in the Federal Register or will be posted on the 
Internet site of the Veterans Health Administration at http://www.va.gov/CBO/apps/rates/index.asp. Certain charges are hereby updated 
as stated in this notice and will be effective on January 1, 2017.
    In cases where VA has not established charges for medical care or 
services provided or furnished at VA expense (by either VA or non-VA 
providers) under other provisions or regulations, the method for 
determining VA's charges is set forth at 38 CFR 17.101(a)(8).
    Based on the methodologies set forth in Sec.  17.101, this notice 
provides an update to charges for 2017 HCPCS Level II and Current 
Procedural Terminology (CPT) codes. Charges are also being updated 
based on more recent versions of data sources for the following charge 
types: Partial hospitalization facility charges; outpatient facility 
charges; physician and other professional charges, including 
professional charges for anesthesia services and dental services; 
pathology and laboratory charges; observation care facility charges; 
ambulance and other emergency transportation charges; and charges for 
durable medical equipment, drugs, injectables, and other medical 
services, items, and supplies identified by HCPCS Level II codes. As of 
the date of this notice, the actual charge amounts at individual VA 
facilities based on the methodologies in Sec.  17.101 will be posted on 
the VHA Internet site at http://www.va.gov/CBO/apps/rates/index.asp 
under the heading ``Reasonable Charges Data Tables'' and identified as 
``v3.21 Data Tables (Outpatient and Professional).''
    The list of data sources used for calculating the actual charge 
amounts listed above also will be posted on the VHA Internet site at 
http://www.va.gov/CBO/apps/rates/index.asp under the heading 
``Reasonable Charges Data Sources'' and identified as ``Reasonable 
Charges v3.21 Data Sources (Outpatient and Professional) (PDF).''
    Acute inpatient facility charges and skilled nursing facility/sub-
acute inpatient facility charges remain the same as set forth in the 
notice published in the Federal Register on September 13, 2016 (80 FR 
57051).
    We are also updating the list of VA medical facility locations. The 
list of VA medical facility locations, including the first three digits 
of their zip codes as well as provider-based/non-provider-based 
designations, will be posted on the VHA Internet site at http://www.va.gov/CBO/apps/rates/index.asp under the heading ``VA Medical 
Facility Locations'' and identified as ``v3.21 (Jan17).''
    As indicated in 38 CFR 17.101(m), when VA provides or furnishes 
prescription drugs not administered during treatment, ``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) includes 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. The 
national average administrative drug cost for calendar year 2017 is 
$16.36. This change will be posted at http://www.va.gov/CBO/payerinfo.asp and identified as ``CY 2017 Average Administrative Cost 
for Prescriptions.''
    Consistent with Sec.  17.101, the national average administrative 
cost, the updated data, and supplementary tables containing the changes 
described in this notice will be posted online, as indicated in this 
notice. This notice will be posted on the VHA Internet site at http://www.va.gov/CBO/apps/rates/index.asp under the heading ``Federal 
Registers, Rules, and Notices'' and identified as ``v3.21 Federal 
Register Notice 01/01/17 (Outpatient and Professional), and National 
Administrative Cost (PDF).'' The national average administrative cost, 
updated data, and supplementary tables containing the changes described 
will be effective until changed by a subsequent Federal Register 
notice.

[[Page 90411]]

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. Gina S. 
Farrisee, Deputy Chief of Staff, Department of Veterans Affairs, 
approved this document on December 9, 2016, for publication.

    Dated: December 9, 2016.
Michael Shores,
Acting Director, Regulation Policy & Management Office of the 
Secretary, Department of Veterans Affairs.
[FR Doc. 2016-30008 Filed 12-13-16; 8:45 am]
 BILLING CODE 8320-01-P

Federal Register / Vol. 81, No. 240 / Wednesday, December 14, 2016 / Notices 90411

Signing Authority correspondence. During the comment DEPARTMENT OF VETERANS
The Secretary of Veterans Affairs, or period, comments may be viewed online AFFAIRS
designee, approved this document and through the FDMS.
authorized the undersigned to sign and Joint Biomedical Laboratory Research
FOR FURTHER INFORMATION CONTACT: and Development and Clinical Science
submit the document to the Office of the Nancy J. Kessinger at (202) 632–8924 or
Federal Register for publication Research and Development Services
FAX (202) 632–8925. Scientific Merit Review Board
electronically as an official document of
the Department of Veterans Affairs. Gina SUPPLEMENTARY INFORMATION: Under the Amended; Notice of Meeting
S. Farrisee, Deputy Chief of Staff, PRA of 1995 (Pub. L. 104–13; 44 U.S.C. The Department of Veterans Affairs
Department of Veterans Affairs, 3501–21), Federal agencies must obtain (VA) gives notice under Public Law 92–
approved this document on December 9, approval from the Office of Management 463; Title 5 U.S.C. App. 2 (Federal
2016, for publication. and Budget (OMB) for each collection of Advisory Committee Act) that the Joint
Dated: December 9, 2016. information they conduct or sponsor. Biomedical Laboratory Research and
Michael Shores, This request for comment is being made Development and Clinical Science
Acting Director, Regulation Policy & pursuant to Section 3506(c)(2)(A) of the Research and Development Services
Management Office of the Secretary, PRA. Scientific Merit Review Board (JBL/CS
Department of Veterans Affairs. With respect to the following SMRB) teleconference meeting will
[FR Doc. 2016–30008 Filed 12–13–16; 8:45 am] convene on January 26, 2017, from 3:00
collection of information, VBA invites
p.m. to 3:45 p.m. and will be open to the
BILLING CODE 8320–01–P comments on: (1) Whether the proposed
public. This Notice of Meeting is being
collection of information is necessary amended due to clarification of the
for the proper performance of VBA’s meeting being open.
DEPARTMENT OF VETERANS
functions, including whether the This meeting is conducted to meet
AFFAIRS
information will have practical utility; with the JBL/CS Service Directors to
[OMB Control No. 2900–0043] (2) the accuracy of VBA’s estimate of the discuss the overall policies and process
burden of the proposed collection of for Merit Review as well as disseminate
Agency Information Collection Activity information; (3) ways to enhance the information among the subcommittee
(Declaration of Status of Dependents
quality, utility, and clarity of the chairs regarding the VA research
(VA Form 21–686c)
information to be collected; and (4) priorities.
AGENCY: Veterans Benefits ways to minimize the burden of the Members of the public who wish to
Administration, Department of Veterans collection of information on attend the open JBL/CS SMRB
Affairs. respondents, including through the use teleconference may dial 1–800–767–
ACTION: Notice. of automated collection techniques or 1750, participant code 95562. Members
the use of other forms of information of the public who wish to make a
SUMMARY: The Veterans Benefits statement at the JBL/CS SMRB meeting
technology.
Administration (VBA), Department of must notify Dr. Alex Chiu, Designated
Veterans Affairs (VA), is announcing an Title: Declaration of Status of Federal Officer, via email at alex.chiu@
opportunity for public comment on the Dependents (VA Form 21–686c). va.gov by January 19, 2017.
proposed collection of certain OMB Control Number: 2900–0043. Dated: December 9, 2016.
information by the agency. Under the
Type of Review: Extension of an LaTonya L. Small,
Paperwork Reduction Act (PRA) of
approved collection. Advisory Committee Management Officer.
1995, Federal agencies are required to
publish notice in the Federal Register Abstract: VA Form 21–686c is [FR Doc. 2016–30025 Filed 12–13–16; 8:45 am]
concerning each proposed collection of necessary to obtain current marital and BILLING CODE P
information, including each proposed dependency information in order to
revision of a currently approved determine the proper rate of payment
collection, and allow 60 days for public for Veterans and surviving spouses who DEPARTMENT OF VETERANS
comment in response to the notice. are entitled to an additional allowance AFFAIRS
VA Form 21–686c is necessary to for dependents. [OMB Control No. 2900–0655]
obtain current marital and dependency
Affected Public: Individuals or
information in order to determine the Agency Information Collection Activity
households. (Residency Verification Report-
proper rate of payment for Veterans and
surviving spouses who are entitled to an Estimated Annual Burden: 56,500 Veterans and Survivors (FL 21–914))
additional allowance for dependents. hours.
AGENCY: Veterans Benefits
DATES: Written comments and Estimated Average Burden per Administration, Department of Veterans
recommendations on the proposed Respondent: 15 minutes. Affairs
collection of information should be
Frequency of Response: One time. ACTION: Notice.
received on or before February 13, 2017.
ADDRESSES: Submit written comments Estimated Number of Respondents: SUMMARY: The Veterans Benefits
on the collection of information through 226,000. Administration (VBA), Department of
Federal Docket Management System Veterans Affairs (VA), is announcing an
sradovich on DSK3GMQ082PROD with NOTICES

By direction of the Secretary:
(FDMS) at www.Regulations.gov or to Cynthia Harvey-Pryor, opportunity for public comment on the
Nancy J. Kessinger, Veterans Benefits VA Clearance Officer, Office of Privacy and
proposed collection of certain
Administration (20M33), Department of Records Management, Department of information by the agency. Under the
Veterans Affairs, 810 Vermont Avenue Veterans Affairs. Paperwork Reduction Act (PRA) of
NW., Washington, DC 20420 or email to [FR Doc. 2016–29980 Filed 12–13–16; 8:45 am]
1995, Federal agencies are required to
nancy.kessinger@va.gov. Please refer to publish notice in the Federal Register
BILLING CODE 8320–01–P
‘‘OMB Control No. 2900–0043’’ in any concerning each proposed collection of

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Document Created: 2016-12-14 00:48:51
Document Modified: 2016-12-14 00:48:51

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
Action		Notice.
Contact		Romona Greene, Office of Community Care, Revenue Operations, Consolidated Patient Account Center (CPAC) Rates and Charges (10D1C), Veterans Health Administration (VHA), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 382-2521. This is not a toll free number.
FR Citation		81 FR 90410