[Federal Register: October 1, 2007 (Volume 72, Number 189)]
[Notices]
[Page 55751-55752]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr01oc07-40]
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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 (FY) 2008
Mental Health Rate Updates
AGENCY: Department of Defense.
ACTION: Notice of updated mental health per diem rates.
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SUMMARY: This notice provides for the updating of institution-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 2008 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 FY 2008.
DATES: Effective Date: The FY 2008 rates contained in this notice are
effective for services occurring on or after October 1.
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 FY. 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 2008, 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 2008 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 2007 updated by 3.4
percent for FY 2008. Partial hospitalization rates for full-day and
half-day programs will also be updated by 3.4 percent for FY 2008. The
cap amount for high-volume hospitals and units will also be updated by
the 3.4 percent for FY 2008. The beneficiary cost share for low volume
hospitals and units will also be updated by the 3.4 percent for FY
2008.
Consistent with Medicare, the wage portion of the regional rate
subject to the area wage adjustment is 75.788 percent for FY 2008. The
following reflect an update of 3.4 percent for FY 2008.
Regional Specific Rates for Psychiatric Hospitals and Units With Low
TRICARE Volume
United States Census Region
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Northeast:
New England.............................................. $707
Mid-Atlantic............................................. 681
Midwest:
East North Central....................................... 588
West North Central....................................... 555
South:
South Atlantic........................................... 701
East South Central....................................... 750
West South Central....................................... 639
West:
Mountain................................................. 638
Pacific.................................................. 754
Puerto Rico.............................................. 481
Beneficiary cost share: Beneficiary cost-share (other than
dependents of Active Duty members) for care paid on the basis of a
regional per diem rate is the lower of $187 per day or 25 percent of
the hospital billed charges effective for services rendered on or after
October 1, 2007.
Cap Amount: Updated cap amount for hospitals and units with high
TRICARE volume is $889 per day for FY 2008.
The following reflect an update of 3.4 percent for FY 2008.
Partial Hospitalization Rates for Full-Day and Half-Day Programs
[Fiscal year 2007]
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Full-day rate (6 Half-day rate (3-
United States Census Region hours or more) 5 hours)
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Northeast:
New England (Maine, N.H., Vt., $284 $214
Mass., R.I., Conn.)..........
Mid-Atlantic:
(N.Y., N.J., Penn.)........... 308 232
Midwest:
East North Central (Ohio, 271 203
Ind., Ill., Mich., Wis.).....
West North Central:
(Minn., Iowa, Mo., N.D., S.D., 271 203
Neb., Kan.)..................
South:
South Atlantic (Del., Md., 292 219
D.C., Va., W.Va., N.C., S.C.,
Ga., Fla.)...................
East South Central:
(Ky., Tenn., Aa., Miss.)...... 315 237
West South Central:
(Ark., La., Texas, Okla.)..... 315 237
West:
Mountain (Mon., Idaho, Wyo., 318 240
Col., N.M., Ariz., Utah,
Nev.)........................
Pacific (Wash., Ore., Calif., 312 234
Alaska, Hawaii)..............
Puerto Rico....................... 203 153
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[[Page 55752]]
The above rates are effective for services rendered on or after
October 1, 2007.
Dated: September 25, 2007.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 07-4829 Filed 9-28-7; 8:45 am]
BILLING CODE 5001-06-M