[Federal Register: October 12, 2006 (Volume 71, Number 197)]
[Notices]               
[Page 60114-60116]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr12oc06-36]                         

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DEPARTMENT OF DEFENSE

Office of the Secretary

 
TRICARE Formerly Known as the Civilian Health and Medical Program 
of the Uniformed Services (CHAMPUS); Fiscal Year 2007 Mental Health 
Rate Updates

AGENCY: Office of the Secretary, DoD.

ACTION:  Notice of updated mental health per diem rates.

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SUMMARY: This notice provides for the updating of hospital-specific per 
diem rates for high volume providers and regional per diem rates for 
low volume providers; the updated cap per diem for high volume 
providers; the beneficiary per diem cost-share amount for low volume 
providers for FY 2007 under the TRICARE Mental Health Per Diem Payment 
System; and the updated per diem rates for both full-day and half-day 
TRICARE Partial Hospitalization Programs for fiscal year 2007.

DATES: Effective Date: The fiscal year 2007 rates contained in this 
notice are effective for services occurring on or after October 1, 
2006.

FOR FURTHER INFORMATION CONTACT: Christine Covie, Office of Medical 
Benefits and Reimbursement Systems, TRICARE Management Activity, 
telephone (303) 676-3841.

SUPPLEMENTARY INFORMATION: The final rule published in the Federal 
Register on September 6, 1988, (53 FR 34285) set forth reimbursement 
changes that were effective for all inpatient hospital admissions in 
psychiatric hospitals and exempt psychiatric units occurring on or 
after January 1, 1989. The final rule published in the Federal Register 
on July 1, 1993, (58 FR 35-400) set forth maximum per diem rates for 
all partial hospitalization admissions on or after September 29, 1993. 
Included in these final rules were provisions for updating 
reimbursement rates for each federal fiscal year. As stated in the 
final rules, each per diem shall be updated by the Medicare update 
factor for hospitals and units exempt from the Medicare Prospective 
Payment System. For fiscal year 2007, Medicare has recommended a rate 
of increase of 3.4 percent for hospitals and units excluded from the 
prospective payment system. TRICARE will adopt this update factor for 
FY 2007 as the final update factor. Hospitals and units with hospital-
specific rates (hospitals and units with high TRICARE volume) and 
regional specific rates for psychiatric hospitals and units with low 
TRICARE volume will have their TRICARE rates for FY 2006 updated by 3.4 
percent for FY 2007. Partial hospitalization rates for full day and 
half day programs will also be updated by 3.4 percent for FY 2007. The 
cap amount for high volume hospitals and units will also be updated by 
the 3.4 percent for FY 2007. The beneficiary cost-share for low volume 
hospitals and units will also be updated by the 3.4 percent for FY 
2007. Consistent with Medicare, the wage portion of the regional rate 
subject to the area wage adjustment is 75.665 percent for FY 2007.

[[Page 60115]]

[GRAPHIC] [TIFF OMITTED] TN12OC06.012

    The following reflect an update of 3.4 percent for FY 2007.

Partial Hospitalization Rates for Full-Day and Half-Day Programs FY 2007
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                                           Full-day rate
       United States census region          (6 hours or    Half-day rate
                                               more)        (3-5 hours)
------------------------------------------------------------------------
Northeast:
    New England (ME, NH, VT, MA, RI, CT)            $275            $207
    Mid-Atlantic (NY, NJ, PA)...........             298             224
Midwest:
    East North Central (OH, IN, IL, MI,              262             196
     WI)................................
    West North Central (MN, IA, MO, ND,              262             196
     SD, NE, KS)........................
South:
    South Atlantic (DE, MD, DC, VA, WV,              282             212
     NC, SC, GA, FL)....................
    East South Central (KY, TN, AL, MS).             305             229
    West South Central (AR, LA, TX, OK).             305             229
West:
    Mountain (MT, ID, WY, CO, NM, AZ,                308             232
     UT, NV)............................
    Pacific (WA, OR, CA, AK, HI)........             302             226

[[Page 60116]]


Puerto Rico                                          196             148
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    The above rates are effective for services rendered on or after 
October 1, 2006.

    Dated: October 5, 2006.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 06-8628 Filed 10-11-06; 8:45 am]

BILLING CODE 5001-06-M