83 FR 47412 - Reasonable Charges for Inpatient MS-DRGs and SNF Medical Services; v3.24, Fiscal Year 2019 Update

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 83, Issue 182 (September 19, 2018)

Page Range		47412-47413
FR Document		2018-20331

This document updates the acute inpatient and the skilled nursing facility (SNF)/sub-acute inpatient facility charges. The updated charges are based on the 2019 Medicare severity diagnosis related groups (MS-DRG).

Federal Register, Volume 83 Issue 182 (Wednesday, September 19, 2018)

[Federal Register Volume 83, Number 182 (Wednesday, September 19, 2018)]
[Notices]
[Pages 47412-47413]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-20331]


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DEPARTMENT OF VETERANS AFFAIRS


Reasonable Charges for Inpatient MS-DRGs and SNF Medical 
Services; v3.24, Fiscal Year 2019 Update

AGENCY: Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: This document updates the acute inpatient and the skilled 
nursing facility (SNF)/sub-acute inpatient facility charges. The 
updated charges are based on the 2019 Medicare severity diagnosis 
related groups (MS-DRG).

FOR FURTHER INFORMATION CONTACT: Romona Greene, Office of Community 
Care, Revenue Operations, Payer Relations and Services, Rates and 
Charges (10D1C1), Veterans Health Administration, 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(a)(1) of Title 38 of the Code 
of Federal Regulations (CFR) sets forth the Department of Veterans 
Affairs (VA) medical regulations concerning ``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 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 2018 MS-DRGs. Acute inpatient facility charges by MS-DRGs are 
posted on the Veterans Health Administration (VHA) Office of Community 
Care's website, at www.va.gov/communitycare/revenue_ops/payer_rates.asp, under the ``Reasonable Charges Data Tables'' section, 
Inpatient Data Table, as Table A (v3.22). This Table A corresponds to 
the Table A referenced in 82 FR 44701, September 25, 2017. Table A 
referenced in this notice is v3.24, which provides updated charges 
based on the 2019 MS-DRGs, will replace Table A (v3.22) posted on the 
VHA Office of Community Care's website.
    Also, this document updates the SNF/sub-acute inpatient facility 
all-inclusive per diem charge using the methodologies set forth in 38 
CFR 17.101(c) and this charge is adjusted by a geographic area factor 
that is based on the location where the care is provided.

[[Page 47413]]

For the geographic area factors, see Table N, Acute Inpatient, and 
Table O, SNF, on the VHA Office of Community Care's website under the 
v3.23 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 Office of Community 
Care's website under the ``Reasonable Charges Data Tables'' section, 
Table B (v3.22). This Table B corresponds to the Table B referenced in 
82 FR 44701, September 25, 2017. Table B referenced in this notice is 
v3.24, which provides an update to the all-inclusive nationwide SNF/
sub-acute inpatient facility per diem charge and will replace Table B 
posted on the VHA Office of Community Care's website.
    The charges in this notice for acute inpatient and SNF/sub-acute 
inpatient facility services are effective October 1, 2018.
    This notice is retaining the table designations used for acute 
inpatient facility charges by MS-DRGs, which is posted on the VHA 
Office of Community Care's website under ``Reasonable Charges Data 
Tables.'' This notice is also retaining the table designation used for 
SNF/sub-acute inpatient facility charges, which is also posted on the 
VHA Office of Community Care's website. Accordingly, the tables 
identified as being updated by this notice correspond to the applicable 
tables referenced in 82 FR 44701, September 25, 2017.
    The list of data sources presented in Supplementary Table 1 (v3.24) 
reflects the updated data sources used to establish the updated charges 
described in this notice, and will be posted on the VHA Office of 
Community Care's website under the ``Reasonable Charges Data Sources'' 
section.
    The list of VA medical facility locations is also updated. In 
Supplementary Table 3, posted on the VHA Office of Community Care's 
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 data tables and 
supplementary tables containing the changes described in this notice 
will be posted on the VHA Office of Community Care's website, under the 
``Payer Rates and Charges'' information section.

Signing Authority

    The Secretary of Veterans Affairs 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. Robert L. 
Wilkie, Secretary, Department of Veterans Affairs, approved this 
document on September 13, 2018 for publication.

    Dated: September 14, 2018.
Luvenia Potts,
Program Specialist, Office of Regulation Policy & Management, Office of 
the Secretary, Department of Veterans Affairs.
[FR Doc. 2018-20331 Filed 9-18-18; 8:45 am]
 BILLING CODE 8320-01-P

47412 Federal Register / Vol. 83, No. 182 / Wednesday, September 19, 2018 / Notices

UNITED STATES SENTENCING meaningful consultation and outreach facility (SNF)/sub-acute inpatient
COMMISSION with tribes, tribal governments, and facility charges. The updated charges
tribal organizations regarding federal are based on the 2019 Medicare severity
Request for Applications; Tribal Issues sentencing issues that have tribal diagnosis related groups (MS–DRG).
Advisory Group implications; (4) to disseminate FOR FURTHER INFORMATION CONTACT:
information regarding federal Romona Greene, Office of Community
AGENCY: United States Sentencing
sentencing issues to tribes, tribal Care, Revenue Operations, Payer
Commission.
governments, and tribal organizations; Relations and Services, Rates and
ACTION: Notice. and (5) to perform any other related Charges (10D1C1), Veterans Health
SUMMARY: In view of an upcoming functions as the Commission requests. Administration, Department of Veterans
vacancy in the at-large membership of The advisory group consists of no more Affairs, 810 Vermont Avenue NW,
the Tribal Issues Advisory Group, the than 9 members, each of whom may Washington, DC 20420, (202) 382–2521
United States Sentencing Commission serve not more than two consecutive (this is not a toll free number).
hereby invites any individual who is three-year terms. Of those 9 members, SUPPLEMENTARY INFORMATION: Section
eligible to be appointed to the at-large not more than 1 shall be a Federal judge; 17.101(a)(1) of Title 38 of the Code of
membership of the Tribal Issues 2 shall be from the Executive Branch Federal Regulations (CFR) sets forth the
Advisory Group to apply. An applicant (one from the United States Department Department of Veterans Affairs (VA)
for membership in the Tribal Issues of Justice and one from the United medical regulations concerning
Advisory Group should apply by States Department of the Interior); 1 ‘‘Reasonable Charges’’ for medical care
sending a letter of interest and resume shall be from a federal public defender or services provided or furnished by VA
to the Commission as indicated in the organization or community defender to a veteran: For a nonservice-connected
ADDRESSES section below. Application
organization; 1 shall be a tribal court disability for which the veteran is
materials should be received by the judge; and not more than 4 shall be at- entitled to care (or the payment of
Commission not later than November large members. expenses of care) under a health plan
Members of the Tribal Issues contract; for a nonservice-connected
19, 2018.
Advisory Group are appointed by the disability incurred incident to the
DATES: Application materials for the at- Commission. To be eligible to serve as
large membership of the Tribal Issues veteran’s employment and covered
a member, an individual must have under a worker’s compensation law or
Advisory Group should be received not expertise, knowledge and/or experience
later than November 19, 2018. plan that provides reimbursement or
in the issues considered by the Tribal indemnification for such care and
ADDRESSES: An applicant for the at-large Issues Advisory Group. The services; or, for a nonservice-connected
membership of the Tribal Issues Commission intends that the at-large disability incurred as a result of a motor
Advisory Group should apply by membership shall include individuals vehicle accident in a State that requires
sending a letter of interest and resume with membership in or experience with automobile accident reparations
to the Commission by electronic mail or tribes, tribal governments, and tribal insurance. The methodologies for
regular mail. The email address is organizations, appointed in a manner establishing billed amounts for several
pubaffairs@ussc.gov. The regular mail that ensures representation among tribal types of charges are found in 38 CFR
address is United States Sentencing communities diverse in size, geographic 17.101; however, this notice will only
Commission, One Columbus Circle NE, location, and other unique address the acute inpatient and the
Suite 2–500, South Lobby, Washington, characteristics. SNF/sub-acute inpatient facility
DC 20002–8002, Attention: Public The Commission invites any charges.
Affairs—TIAG Membership. individual who is eligible to be Based on the methodologies set forth
FOR FURTHER INFORMATION CONTACT: appointed to the at-large membership of in 38 CFR 17.101(b), this notice updates
Christine Leonard, Director, Office of the Tribal Issues Advisory Group to the acute inpatient facility charges that
Legislative and Public Affairs, (202) apply by sending a letter of interest and were based on the 2018 MS–DRGs.
502–4500, pubaffairs@ussc.gov. More a resume to the Commission as Acute inpatient facility charges by MS–
information about the Tribal Issues indicated in the ADDRESSES section DRGs are posted on the Veterans Health
Advisory Group is available on the above. Administration (VHA) Office of
Commission’s website at http:// Authority: 28 U.S.C. 994(a), (o), (p), 995; Community Care’s website, at
www.ussc.gov/about/who-we-are/ USSC Rules of Practice and Procedure 5.4. www.va.gov/communitycare/revenue_
advisory-groups. ops/payer_rates.asp, under the
William H. Pryor Jr.,
SUPPLEMENTARY INFORMATION: The Tribal ‘‘Reasonable Charges Data Tables’’
Acting Chair.
Issues Advisory Group is a standing section, Inpatient Data Table, as Table A
[FR Doc. 2018–20311 Filed 9–18–18; 8:45 am]
advisory group of the United States (v3.22). This Table A corresponds to the
Sentencing Commission pursuant to 28 BILLING CODE 2210–40–P
Table A referenced in 82 FR 44701,
U.S.C. 995 and Rule 5.4 of the September 25, 2017. Table A referenced
Commission’s Rules of Practice and in this notice is v3.24, which provides
Procedure. Under the charter for the DEPARTMENT OF VETERANS updated charges based on the 2019 MS–
Tribal Issues Advisory Group, the AFFAIRS DRGs, will replace Table A (v3.22)
purpose of the advisory group is (1) to posted on the VHA Office of
assist the Commission in carrying out its Reasonable Charges for Inpatient MS–
Community Care’s website.
amozie on DSK3GDR082PROD with NOTICES1

statutory responsibilities under 28 DRGs and SNF Medical Services; Also, this document updates the SNF/
U.S.C. 994(o); (2) to provide to the v3.24, Fiscal Year 2019 Update sub-acute inpatient facility all-inclusive
Commission its views on federal AGENCY: Department of Veterans Affairs. per diem charge using the
sentencing issues relating to American ACTION: Notice. methodologies set forth in 38 CFR
Indian and Alaska Native defendants 17.101(c) and this charge is adjusted by
and victims, and to offenses committed SUMMARY: This document updates the a geographic area factor that is based on
in Indian country; (3) to engage in acute inpatient and the skilled nursing the location where the care is provided.

VerDate Sep<11>2014 17:09 Sep 18, 2018 Jkt 244001 PO 00000 Frm 00085 Fmt 4703 Sfmt 4703 E:\FR\FM\19SEN1.SGM 19SEN1

$Federal Register / Vol. 83, No. 182 / Wednesday, September 19, 2018 / Notices 47413 For the geographic area factors, see Community Care’s website under codes and provider-based/non-provider- Table N, Acute Inpatient, and Table O, ‘‘Reasonable Charges Data Tables.’’ This based designations. SNF, on the VHA Office of Community notice is also retaining the table Consistent with VA’s regulations, the Care’s website under the v3.23 link in designation used for SNF/sub-acute updated data tables and supplementary the ‘‘Reasonable Charges Data Tables’’ inpatient facility charges, which is also tables containing the changes described section. Tables N and O are not being posted on the VHA Office of in this notice will be posted on the VHA updated by this notice. The SNF/sub- Community Care’s website. Office of Community Care’s website, acute inpatient facility per diem charge Accordingly, the tables identified as under the ‘‘Payer Rates and Charges’’ is posted on the VHA Office of being updated by this notice correspond information section. Community Care’s website under the to the applicable tables referenced in 82 Signing Authority ‘‘Reasonable Charges Data Tables’’ FR 44701, September 25, 2017. section, Table B (v3.22). This Table B The Secretary of Veterans Affairs corresponds to the Table B referenced in The list of data sources presented in approved this document and authorized 82 FR 44701, September 25, 2017. Table Supplementary Table 1 (v3.24) reflects the undersigned to sign and submit the B referenced in this notice is v3.24, the updated data sources used to document to the Office of the Federal which provides an update to the all- establish the updated charges described Register for publication electronically as inclusive nationwide SNF/sub-acute in this notice, and will be posted on the an official document of the Department inpatient facility per diem charge and VHA Office of Community Care’s of Veterans Affairs. Robert L. Wilkie, will replace Table B posted on the VHA website under the ‘‘Reasonable Charges Secretary, Department of Veterans Office of Community Care’s website. Data Sources’’ section. Affairs, approved this document on The charges in this notice for acute The list of VA medical facility September 13, 2018 for publication. inpatient and SNF/sub-acute inpatient locations is also updated. In Dated: September 14, 2018. facility services are effective October 1, Supplementary Table 3, posted on the Luvenia Potts, 2018. VHA Office of Community Care’s Program Specialist, Office of Regulation This notice is retaining the table website under the VA Medical Facility Policy & Management, Office of the Secretary, designations used for acute inpatient Locations section, VA set forth the list Department of Veterans Affairs. facility charges by MS–DRGs, which is of VA medical facility locations, which [FR Doc. 2018–20331 Filed 9–18–18; 8:45 am] posted on the VHA Office of includes the first three digits of their zip BILLING CODE 8320–01–P amozie on DSK3GDR082PROD with NOTICES1 VerDate Sep<11>2014 17:09 Sep 18, 2018 Jkt 244001 PO 00000 Frm 00086 Fmt 4703 Sfmt 9990 E:\FR\FM\19SEN1.SGM 19SEN1$

Document Created: 2018-09-19 02:55:50
Document Modified: 2018-09-19 02:55:50

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, Payer Relations and Services, Rates and Charges (10D1C1), Veterans Health Administration, Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, (202) 382-2521 (this is not a toll free number).
FR Citation		83 FR 47412